Clinical features and prognosis of sebaceous carcinoma arising in the eyelid or conjunctiva
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CLINICAL INVESTIGATION
Clinical features and prognosis of sebaceous carcinoma arising in the eyelid or conjunctiva Hiroshi Goto1 · Kinya Tsubota1 · Rei Nemoto1 · Shunichiro Ueda1 · Kazuhiko Umazume1 · Yoshihiko Usui1 · Hajme Matsumura2 Received: 22 January 2020 / Accepted: 21 May 2020 © Japanese Ophthalmological Society 2020
Abstract Purpose The aim of this study was to clarify the demographics, clinical features, and outcomes of Japanese patients with sebaceous carcinoma of the eyelid or conjunctiva. Study design Retrospective study. Methods One hundred twenty-five patients with sebaceous carcinoma of the eyelid or conjunctiva diagnosed at Tokyo Medical University Hospital between 1994 and 2017 were reviewed. The outcomes of the 116 patients who were treated and followed for at least 24 months at our hospital were investigated. Results The patients reviewed comprised 52 men and 74 women. The average age at diagnosis was 70.6 ± 13.8 (range 31–96) years. The main lesion was located in the upper eyelid in 51% of the patients; in the lower eyelid in 38% of the patients; and in other regions in 11% of the patients. Treatments included surgical resection with or without eyelid reconstruction in 108 cases (93%), orbital exenteration in 5 cases (4%), and radiation therapy in 3 cases (3%). Local recurrence was detected in 11 cases (9%). Metastasis to the regional lymph nodes was confirmed in 10 cases (9%). Four patients (3%) died because of direct intracranial invasion of the tumor. Risk of local recurrence and metastasis was significantly related to larger tumor size. Conclusion Proper diagnosis and treatment at the optimal timing is critical to improve the outcome of sebaceous carcinoma of the eyelid or conjunctiva. Long-term follow-up is required because local recurrence and metastasis may occur several years after treatment. Keywords Conjunctiva · Eyelid · Prognosis · Sebaceous carcinoma
Introduction Sebaceous carcinoma arising in the eyelid or conjunctiva is often misdiagnosed and mismanaged as a benign condition such as chronic blepharitis, conjunctivitis, and chalazion, resulting in an unfavorable outcome [1–5]. Sebaceous carcinoma is a relatively common malignant ocular adnexal tumor in Asian and Indian populations as compared with in white populations [3, 6–9]. Treatments for sebaceous Corresponding Author: Hiroshi Goto * Hiroshi Goto goto1115@tokyo‑med.ac.jp 1
Department of Ophthalmology, Tokyo Medical University, 6‑7‑1 Nishi‑Shinjuku, Shinjuku‑ku, Tokyo 160‑0023, Japan
Department of Plastic Surgery, Tokyo Medical University, Tokyo, Japan
2
carcinoma of the eyelid include local resection of the tumor and reconstruction of the eyelid, local chemotherapy using mitomycin C or interferon alpha-2b for intraepithelial invasion, orbital exenteration in advanced cases, and external beam radiation therapy [1–5]. Local recurrence and metastasis are critical issues in the management of eyelid sebaceous carcinomas. However, the optimal follow-up after treatment remains unclear. The purpose of this study wa
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