Sebaceous Carcinoma of the Ocular Region: A Review

British Journal of Ophthalmology, 2013

IP International Journal of Ocular Oncology and Oculoplasty

Ocular sebaceous gland carcinoma (SGC) is a relatively rare, slow growing, but most aggressive and life-threatening tumor. It accounts for around 1% of all cutaneous malignancies. In Caucasians, SGCs are rare accounting for 1-5.5% of eyelid malignancies with a high incidence rate (28-60%) reported in the Asian population. In most SGCs no obvious etiology has been identified but few cases are associated with Muir-Torre syndrome. The dysregulation of several cell signaling pathways has been reported in tumorigenesis of SGC. Recently genome sequencing of periocular SGC revealed several gene mutations like TP53 and RB1 genes. Ocular SGC is known as the ‘great masquerader’ as it mimics several benign and inflammatory conditions like chalazion and chronic blepharitis/ blepharoconjunctivitis which may be responsible for delayed diagnosis and high mortality. Clinico-pathologically ocular SGC can be broadly categorized into nodular and pagetoid subtypes. The latter is more aggressive and ass...

British Journal of Ophthalmology, 1998

Background-Sebaceous carcinoma of the eyelid is rare. The diagnosis might be diYcult because of its ability to masquerade as other periocular lesions. Prognosis is still regarded as being poor compared with most other malignant eyelid tumours with a mortality second only to malignant melanoma. The present study retrospectively analyses clinical and histopathological findings and outcome in a series of patients with sebaceous carcinoma of the eyelid in Britain. Methods-43 patients with histologically confirmed sebaceous carcinoma treated at Moorfields Eye Hospital between 1976 and 1992 were subjected to retrospective analysis. Clinical data of all patients were reviewed from the charts; all surviving patients except four cases lost for follow up were reexamined. Histological specimens were reviewed in 41 cases. Results-23 females and 20 males, mean age 63 years (range 37-79), were treated. Primary therapy was surgery in 37 and radiotherapy in six cases. After a median follow up of 40 months (range 1-148) 30 patients were alive without recurrences, four patients had died from the tumour, and one was alive with local recurrence and distant metastases. Four patients had died of non-tumour related causes. Histologically, unfavourable outcome was correlated with poor tumour diVerentiation and extensive invasion. Conclusion-Early diagnosis and consequent surgical therapy of sebaceous carcinoma of the eyelid leads to a better outcome and higher survival rates than generally assumed. Even local recurrences can be treated successfully. However, sebaceous carcinoma remains a threatening disease, which leads to death in 9% and to mutilating exenteration in 23% of our patients.

European Journal of Medical and Health Sciences

Palpebral sebaceous carcinoma (PSC) is a rare malignant disease. Despite the possibility of extraocular location, the ocular region is the most described site in the literature. This tumor is poorly known and can mimic various benign conditions, explaining the frequent diagnostic delays. We report a new observation of sebaceous carcinoma in a 59-year-old patient and a review of the literature. It mainly affects the elderly with a female predominance. Its location in the upper eyelid remains the most common site, unlike our patient who presented with a lower eyelid disease. Surgery seems to be the treatment of choice for local sebaceous cell carcinoma, the role of radiotherapy is still to be clearly defined but the studies detailed in our paper have confirmed its effectiveness in inoperable patients or patients with advanced local disease, the use of chemotherapy during or before radiotherapy remains to be clarified.

2016

Purpose: The objective of this study was to analyze clinical presentation, histopathological spectrum and outcome of ocular sebaceous gland carcinoma in a teaching hospital. Materials and Methods: The prospective study was carried out at the Ocular oncology and oculoplasty unit, department of ophthalmology, Institute of Medical Sciences, Banaras Hindu University, Varanasi from March 2014 to February 2016. 34 patients with suspected sebaceous gland carcinoma were enrolled from outpatient department. All patients were admitted to ward and underwent detailed history, clinical, radiological evaluation and necessary laboratory investigations. In each case incisional/ excisional biopsy were taken to study the histopathological characteristics. All patients were treated either surgically or non-surgically by single ocular oncologist. Pre and post treatment clinical photographs were taken to compare structural outcome and for purpose of documentation. Data were recorded in predesigned profo...

Ophthalmic Plastic and Reconstructive Surgery, 2015

European Journal of Surgical Oncology, 2020

Background: Sebaceous carcinoma (SC) is a rare malignant tumour whereby, comprehensive long-term data are scarce. This study aimed to assess the outcome of patients treated with resection for SC. Methods: Patients treated at four tertiary centres were included. Cumulative incidence curves were calculated for recurrences. Results: A total of 100 patients (57 males, 57%) were included with 103 SCs. The median age was 72 (range, 15-95) years with a median follow-up of 52 (interquartile range [IQR], 24-93) months. Most SCs were located (peri)ocular (49.5%). Of all SCs, 17 locally recurred (16.5%) with a median time to recurrence of 19 (IQR, 8-29) months. The cumulative incidence probability for recurrence was statistically higher for (peri)ocular tumours (p = 0.005), and for positive resection margins (p = 0.001). Two patients presented with lymph node metastases and additional seven patients (8.7%) developed lymph node metastases during follow-up with a median time to metastases of 8 (IQR, 0.5-28) months. Three patients had concurrent in-transit metastases and one patient also developed liver and bone metastases during follow-up. Conclusion: SC is a rare, yet locally aggressive tumour. Positive resection margins and (peri)ocular SCs are more frequently associated with local recurrence. SC infrequently presents with locoregional or distant metastases.

2022

Background: Sebaceous carcinomas are rare, aggressive, malignant tumors that arise from sebaceous glands. They can be ocular or extraocular. They exhibit a variety of histologic growth patterns and diverse clinical presentations. Metastases are rarely reported. Observation: A 79 year old woman presented to our department with a quickly enlarging nodule involving the mid part of her forehead 2 weeks before admission. Histological examination found a sebaceous carcinoma. The patient underwent a total excision of the lesion, and was scheduled for Radiotherapy. She was lost to follow and returned 6 months later with a right latero cervical mass related to lymph node metastasis. Conclusion: Extraocular sebaceous carcinomas represent about 25% of all sebaceous carcinomas. The available literature on treatment recommends wide surgical excision with tumor-free margins with removal of regional lymph nodes, followed sometimes by adjuvant radiotherapy. Unlike our case where the evolution was quickly aggressive, these tumors were classically considered to be a less offensive neoplasm than their ocular equivalent.

Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2013

Sebaceous gland carcinoma of the eyelid is a rare slow-growing tumor and is one of the most aggressive malignancies of the eyelid. Diagnosis is often delayed because it can be confused with other periocular lesions. We report the case of a 78-year-old female who presented for the anesthetic aspect of a nodular tumor on the right upper eyelid occurring one year earlier. The patient was treated for three months for recurrent chalazion. Ophthalmologic examination revealed a nodular ulcerated tumor of 1 cm in size adherent to adjacent tissues. Surgical excision was performed with a safety margin of 4 mm. The diagnosis of moderately differentiated sebaceous carcinoma was made by routine morphological methods and immunohistochemical reactions (EMA and Ki-67). Being a rare tumor with considerable morbidity and mortality, early diagnosis and proper treatment are essential for a favorable prognosis and preservation of visual function.

Archivos de la Sociedad Española de Oftalmología (English Edition), 2010

A 40-year-old woman was referred to our department due to an apparent indolent anterior blepharitis with an indurated node in her right upper eyelid, which had persisted for months. It was believed to be a chalazion associated with an ipsilateral swollen pre-aurical lymph node, which had not responded to conventional treatment. The extemporaneous biopsy was reported as sebaceous carcinoma. Complete exeresis was performed on that eyelid and it was reconstructed with a palate mucosa graft and a glabelar flap. A radical neck dissection was performed later, in order to remove the lymph nodes that appeared necrotic in several lymphatic areas. A biopsy was also performed on the lower eyelid, which was reported as positive for carcinomatous infiltration, and therefore it was treated with Curie-therapy. Discussion: The precocity in diagnosing sebaceous carcinomas of the eyelids is the main prognostic factor. The reconstruction in cases with need of complete eyelid exeresis is feasible by means of a palate mucosa graft. In our case, both the anaplastic character and the high aggressiveness of the neoplasm were a therapeutic challenge.