ABSTRACT
Sebaceous carcinoma is a rare malignant tumor of the skin. Although this tumor is not completely understood due to its rarity and the paucity of published reports, it is known to be an aggressive tumor with a high incidence in Asia. Sebaceous carcinomas occur preferentially in the periocular region and require attention not to miss the associated Muir-Torre syndrome. In the case of localized disease, a wide local excision with clear margin followed by adjuvant radiation therapy is usually considered the standard treatment strategy but there is no agreed treatment strategy or standard chemotherapeutic regimen for recurrent metastatic sebaceous carcinoma. We report here two cases of recurrent metastatic sebaceous carcinoma patients who responded to 5-fluorouracil and cisplatin combination chemotherapy, and review the literature. We suggest that 5-fluorouracil-cisplatin can be considered a feasible and effective treatment modality for recurrent sebaceous carcinoma.
Subject(s)
Adenocarcinoma, Sebaceous/drug therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Neoplasm Recurrence, Local/drug therapy , Palliative Care/methods , Sebaceous Gland Neoplasms/drug therapy , Adenocarcinoma, Sebaceous/pathology , Aged , Asia , Cisplatin/administration & dosage , Cisplatin/adverse effects , Female , Fluorouracil/administration & dosage , Fluorouracil/adverse effects , Humans , Male , Middle Aged , Neoplasm Recurrence, Local/pathology , Sebaceous Gland Neoplasms/pathologyABSTRACT
We review the use of three topical medications for the therapy of ocular surface tumors: mitomycin C, 5-fluorouracil, and interferon alpha-2B. One hundred sixty patients with histologically or cytologically proven epithelial and melanocytic tumors were identified in the literature. Side effects occurred most often with mitomycin C, followed by 5-fluorouracil, and interferon alpha-2B. Patients most frequently experienced transient keratitis, redness, and irritation. Topical agents were used as both primary and adjuvant therapy. Rates of tumor regression for CIN and squamous cell carcinoma ranged from 80 to 96%, and 70% of pigmented tumors regressed after an average follow-up of 27 months.
Subject(s)
Antineoplastic Agents/administration & dosage , Conjunctival Neoplasms/drug therapy , Corneal Diseases/drug therapy , Eye Neoplasms/drug therapy , Administration, Topical , Antineoplastic Agents/adverse effects , Carcinoma in Situ/drug therapy , Carcinoma in Situ/pathology , Carcinoma, Squamous Cell/drug therapy , Carcinoma, Squamous Cell/pathology , Conjunctival Neoplasms/pathology , Corneal Diseases/pathology , Eye Neoplasms/pathology , Fluorouracil/administration & dosage , Fluorouracil/adverse effects , Humans , Interferon alpha-2 , Interferon-alpha/administration & dosage , Interferon-alpha/adverse effects , Lymphoma/drug therapy , Lymphoma/pathology , Mitomycin/administration & dosage , Mitomycin/adverse effects , Recombinant Proteins , Sebaceous Gland Neoplasms/drug therapy , Sebaceous Gland Neoplasms/pathologyABSTRACT
A 55-year-old Asian Indian woman who had recurrent sebaceous gland carcinoma of the left lower eyelid with orbital extension and regional lymph node metastasis was treated with neoadjuvant chemotherapy, using a combination of carboplatin and 5-fluorouracil. Eyelid-sparing orbital exenteration was performed after 3 cycles of chemotherapy, followed by radiotherapy to the regional lymph nodes. Subsequently, 3 cycles of adjuvant chemotherapy were administered. Significant eyelid and orbital tumor volume reduction was achieved with neoadjuvant chemotherapy, making eyelid-sparing orbital exenteration possible. Chemotherapy also spared the patient from radical neck dissection. The patient had limited morbidity and was free of local, regional, and systemic disease at 26 months of follow-up.