Surgical treatment of a solitary pulmonary metastasis from eyelid sebaceous carcinoma: report of a case
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WORLD JOURNAL OF SURGICAL ONCOLOGY
CASE REPORT
Open Access
Surgical treatment of a solitary pulmonary metastasis from eyelid sebaceous carcinoma: report of a case Kaoru Kaseda1, Takashi Ohtsuka1*, Yuichiro Hayashi2, Katsura Emoto2, Keisuke Asakura1, Ikuo Kamiyama1, Taichiro Goto1 and Mitsutomo Kohno1
Abstract Background: Ocular sebaceous carcinoma is an uncommon, aggressive ocular neoplasm with potential for regional and distant metastasis. Case presentation: A 77-year-old woman was found to have a solitary pulmonary lesion 6 years after the initial treatment of sebaceous carcinoma of the eyelid. Video-assisted lung wedge resection of an undetermined pulmonary nodule was carried out successfully. Microscopically, the tumor showed foamy cytoplasm and atypical nuclei, consistent with metastasis of eyelid sebaceous carcinoma. Conclusion: This is the first case report of resected solitary pulmonary metastasis of eyelid sebaceous carcinoma. Pulmonary resection is a good option for the treatment and diagnosis of metastatic eyelid sebaceous carcinoma. Keywords: Sebaceous carcinoma, Lung metastasis, Solitary metastasis
Background Sebaceous carcinoma of the eyelid is a relatively rare malignant tumor, and accounts for less than 1% of all eyelid tumors [1]. As well as being a rare tumor, sebaceous carcinoma can mimic other benign inflammatory and malignant processes, thus errors or delays in diagnosis are not unusual [2-5]. Although local management strategies for this tumor have previously been described [6-10], very few reports have focused on the patterns of metastasis of this tumor and the treatment strategies for such metastases [7,8]. Here, we report a case of solitary lung metastasis of eyelid sebaceous carcinoma, and discuss the clinical implication of surgery for a solitary pulmonary metastasis from sebaceous carcinoma. Case presentation A 77-year-old woman underwent left upper lid resection in April 2006 for sebaceous carcinoma of the eyelid. The surgical margin was negative for cancer cells. In January * Correspondence: [email protected] 1 Department of Surgery, Section of General Thoracic Surgery, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan Full list of author information is available at the end of the article
2008, she had developed a recurrence in the left upper eyelid, and underwent radiotherapy with a total dose of 57.6 Gy of proton beam therapy followed by orbital exenteration of the left eye [11,12]. In July 2012, positron emission tomography–computed tomography (PET-CT) revealed a solitary pulmonary nodule 0.5 cm in size in the right upper lobe of the patient’s lung, which had increased to 1.1 cm by September 2013 (Figure 1A). PET-CT revealed a focus of increased uptake in that nodule, with a standardized uptake value of 3.7 (Figure 1B). There was no evidence of other metastatic disease on PET-CT scans. In September 2013, the patient underwent video-assisted thoracoscopic wedge resection of the pulmonary nodule. Frozen sections using oil red O stain revealed accentuation o
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