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Br J Ophthalmol. Sep 1998; 82(9): 1049–1055.
PMCID: PMC1722731

Sebaceous carcinoma of the eyelid: a clinicopathological study

Abstract

BACKGROUND—Sebaceous carcinoma of the eyelid is rare. The diagnosis might be difficult 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 re-examined. 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 differentiation 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.

Keywords: sebaceous carcinoma; adenocarcinoma; meibomian gland carcinoma; malignant tumour; eyelid

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Selected References

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Figures and Tables

Figure 1
(A) Sebaceous carcinoma of the left upper lid presenting as a firm, nodular, and non-tender mass. (B) Same lid everted with the lesion originating from the tarsal plate.
Figure 2
Sebaceous carcinoma presenting as a chronic blepharoconjunctivitis in the right eye.
Figure 3
Sebaceous carcinoma presenting as a basal cell carcinoma of the left lower lid.
Figure 4
Well differentiated lobular sebaceous carcinoma with minimal stromal infiltration (original magnification ×190).
Figure 5
Poorly differentiated sebaceous carcinoma with extensive stromal infiltration (original magnification×190).
Figure 6
Sebaceous carcinoma with pagetoid spread in the form of groups of tumour cells infiltrating and replacing the basal layers of the epithelium (original magnification ×190).
Figure 7
Sebaceous carcinoma with full thickness replacement of the surface epithelium by tumour tissue (original magnification×190)

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