The rare adenocarcinoma arises from the meibomian glands or the glands of Zeis. The firm, painless swelling is usually located in the upper eyelid and is mobile with respect to the skin but not with respect to the underlying tissue. In its early stages it can be mistaken easily for a chalazion. The lesion can metastasize into local lymph nodes.
An apparent chalazion that cannot be removed by the usual surgical procedure always suggests a suspected adenocarcinoma.
The treatment of choice is complete surgical removal.