A Case of Primary Sebaceous Carcinoma of the Lacrimal Gland

ABSTRACT

PURPOSE: To report a case of very limited primary sebaceous carcinoma of the lacrimal gland that soon recurred and rapidly progressed after excision and radiotherapy. METHODS: A 67-year-old man presented to our clinic with a history of proptosis in his right eye for 1 month. On physical examination, 4mm exophthalmos and a palpable mass at the superotemporal area of the lacrimal gland without tenderness were noted in his right eye. The eyelid was entirely normal on examination. A CT scan was taken which showed a heterogenous mass in the lacrimal gland area. We performed surgical excision and biopsy of the mass through lateral orbitotomy. RESULTS: Primary sebaceous carcinoma of the lacrimal gland was diagnosed pathologically. A 63-Gy electron beam was irradiated for 6 weeks. Five months after the operation, a large mass was again palpable at the superotemporal orbital area. MRI revealed recurrence of the sebaceous carcinoma and its metastasis to the brain. Systemic metastasis in multiple organs was noted on PET scan. CONCLUSIONS: As primary sebaceous carcinoma of the lacrimal gland has a very poor prognosis, aggressive treatment such as exenteration should be considered, and a CT scan should be taken early on to find any recurrence or metastasis.