RESUMEN
PURPOSE: To report the outcomes of platinum-based neoadjuvant chemotherapy (NACT) for eyelid and periocular sebaceous gland carcinoma (eSGC). METHODS: Retrospective study of 25 patients. RESULTS: The mean age at presentation of eSGC was 59 years. The mean tumor basal diameter was 46 mm. By the 8th edition of AJCC classification, tumors belonged T2 (n = 2, 8%), T3 (n = 6, 24%), and T4 (n = 17, 68%); N1 (n = 12,48%); and M1 (n = 1, 4%). NACT with 5-fluorouracil (5-FU) and cisplatin/carboplatin was administered in 21 (84%)/4 (16%) patients, respectively. The mean number of cycles of neoadjuvant systemic chemotherapy per patient was 2 (median, 3). The mean percentage reduction of tumor basal volume after neoadjuvant chemotherapy was 65% (median, 60%). After NACT, 12 (48%) patients underwent surgical treatment, 6 (12%) patients underwent EBRT, and 4 (8%) underwent adjuvant chemotherapy. A total of 11 (44%) patients were lost to follow-up during the course of treatment, of whom 3 died from metastatic disease. In 16 patients followed up for ≥ 3 months, complete tumor control was achieved in 11 (69%) patients, local tumor control in 14 (88%), and globe salvage in 7 (44%) at a mean follow-up of 25 months (median, 7 months; range, 3 to 110 months). No tumor recurrence was seen in any case. One (4%) serious adverse event of cardiotoxicity was noted. CONCLUSION: Platinum-based NACT is a suitable option for eSGC with advanced tumors and locoregional metastasis. Adverse events are rare and in patients compliant with treatment, NACT-based combination therapy offers globe salvage and systemic tumor control.
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Neoplasias de los Párpados , Terapia Neoadyuvante , Neoplasias de las Glándulas Sebáceas , Humanos , Persona de Mediana Edad , Masculino , Femenino , Estudios Retrospectivos , Neoplasias de los Párpados/tratamiento farmacológico , Neoplasias de los Párpados/diagnóstico , Neoplasias de los Párpados/patología , Neoplasias de las Glándulas Sebáceas/tratamiento farmacológico , Neoplasias de las Glándulas Sebáceas/cirugía , Neoplasias de las Glándulas Sebáceas/diagnóstico , Neoplasias de las Glándulas Sebáceas/patología , Terapia Neoadyuvante/métodos , Anciano , Adulto , Adenocarcinoma Sebáceo/tratamiento farmacológico , Adenocarcinoma Sebáceo/diagnóstico , Adenocarcinoma Sebáceo/patología , Adenocarcinoma Sebáceo/cirugía , Estudios de Seguimiento , Cisplatino/administración & dosificación , Cisplatino/uso terapéutico , Anciano de 80 o más Años , Fluorouracilo/administración & dosificación , Fluorouracilo/uso terapéutico , Quimioterapia Adyuvante/métodos , Carboplatino/administración & dosificación , Carboplatino/uso terapéutico , Estadificación de Neoplasias , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Resultado del TratamientoRESUMEN
Here we present the first case of sebaceous carcinoma of the middle ear. We discuss the treatment course and post treatment results after 11 years of follow up. We further summarize the available literature of sebaceous carcinoma of the temporal bone, which prior to this case was exclusively limited to the external auditory canal. Laryngoscope, 134:3769-3772, 2024.
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Adenocarcinoma Sebáceo , Neoplasias del Oído , Oído Medio , Humanos , Neoplasias del Oído/patología , Neoplasias del Oído/cirugía , Neoplasias del Oído/diagnóstico , Oído Medio/patología , Oído Medio/diagnóstico por imagen , Adenocarcinoma Sebáceo/patología , Adenocarcinoma Sebáceo/diagnóstico , Adenocarcinoma Sebáceo/cirugía , Neoplasias de las Glándulas Sebáceas/patología , Neoplasias de las Glándulas Sebáceas/diagnóstico , Neoplasias de las Glándulas Sebáceas/cirugía , Masculino , Anciano , Femenino , Persona de Mediana EdadRESUMEN
BACKGROUND: Sebaceous carcinoma is a very rare malignant skin adnexal tumor that is occasionally aggressive. We have not seen a case of sebaceous carcinoma in our center in the last 10 years. It is extremely rare in Black Africans. CASE PRESENTATION: We described the case of a 55-year-old man African man who presented to our ophthalmologist with complaints of growth on the right upper eyelid for 8 months. He had surgery and chemotherapy for rectal carcinoma 6 years prior to presentation and received his last dose of chemotherapy 5 years before seeing our ophthalmologist. There was a history of spontaneous unprovoked bleeding from the lesion. He subsequently underwent surgical excision under general anesthesia. Histology of the mass showed an effaced architecture due to proliferating malignant epithelial cells disposed as trabecules, solid nests, and tongues. The microscopic features of widespread multivacuolated cytoplasm of the neoplastic cells led us to conclude that the tumor was a sebaceous carcinoma. The patient is alive and well. CONCLUSION: Sebaceous carcinoma is a rare malignant skin adnexal tumor in Black Africans. It can present as an eyelid mass with spontaneous bleeding. It can follow cancer chemotherapy either because of its association with other tumors in Muir-Torre syndrome or because of mutagenic effects of chemotherapeutic agents.
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Adenocarcinoma Sebáceo , Blefaroptosis , Síndrome de Muir-Torre , Neoplasias de las Glándulas Sebáceas , Masculino , Humanos , Persona de Mediana Edad , Adenocarcinoma Sebáceo/patología , Adenocarcinoma Sebáceo/cirugía , Neoplasias de las Glándulas Sebáceas/patología , Neoplasias de las Glándulas Sebáceas/cirugíaRESUMEN
Sebaceous gland carcinoma is a rare and aggressive skin cancer derived from the sebaceous glands. Sebaceous carcinomas are divided into those occurring in ocular (75%) and extra-ocular locations. A 45-year-old female patient presented with rapidly growing swelling over the upper back region. It was provisionally diagnosed as an infected sebaceous cyst, and an excision biopsy was received in the pathology department. Histopathology was reported as sebaceous carcinoma, Grade II, Stage P T3 Nx. Immunohistochemistry was positive for epithelial membrane antigen. Sebaceous carcinoma accounts for 0.2-4.6% of all malignant cutaneous neoplasms, and the estimated rate of occurrence is only 1-2 per 1 million individuals per year. These tumors frequently present with a painless sub-cutaneous nodule, but they can also present as pedunculated lesions, irregular mass, or diffuse thickening of the skin. Hence, they are misinterpreted as other benign tumors or inflammatory conditions, thereby leading to delay in diagnosis, inappropriate treatment, increased morbidity, and mortality.
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Adenocarcinoma Sebáceo , Neoplasias de las Glándulas Sebáceas , Neoplasias Cutáneas , Femenino , Humanos , Persona de Mediana Edad , Adenocarcinoma Sebáceo/diagnóstico , Adenocarcinoma Sebáceo/patología , Adenocarcinoma Sebáceo/cirugía , Neoplasias de las Glándulas Sebáceas/diagnóstico , Neoplasias de las Glándulas Sebáceas/patología , Neoplasias de las Glándulas Sebáceas/cirugía , Neoplasias Cutáneas/patología , Piel/patología , Glándulas Sebáceas/patologíaAsunto(s)
Adenocarcinoma Sebáceo , Neoplasias de las Glándulas Sebáceas , Neoplasias Cutáneas , Humanos , Queratina-7 , Cirugía de Mohs , Adenocarcinoma Sebáceo/cirugía , Adenocarcinoma Sebáceo/patología , Neoplasias Cutáneas/cirugía , Neoplasias Cutáneas/patología , Neoplasias de las Glándulas Sebáceas/cirugía , Neoplasias de las Glándulas Sebáceas/patologíaRESUMEN
Personalized medicine aims to develop tailored treatments for individual patients based on specific mutations present in the affected organ. This approach has proven paramount in cancer treatment, as each tumor carries distinct driver mutations that respond to targeted drugs and, in some cases, may confer resistance to other therapies. Particularly for rare conditions, personalized medicine has the potential to revolutionize treatment strategies. Rare cancers often lack extensive datasets of molecular and pathological information, large-scale trials for novel therapies, and established treatment guidelines. Consequently, surgery is frequently the only viable option for many rare tumors, when feasible, as traditional multimodal approaches employed for more common cancers often play a limited role. Sebaceous carcinoma of the eyelid is an exceptionally rare cancer affecting the eye's adnexal tissues, most frequently reported in Asia, but whose prevalence is significantly increasing even in Europe and the US. The sole established curative treatment is surgical excision, which can lead to significant disfigurement. In cases of metastatic sebaceous carcinoma, validated drug options are currently lacking. In this project, we set out to characterize the mutational landscape of two sebaceous carcinomas of the eyelid following surgical excision. Utilizing available bioinformatics tools, we demonstrated our ability to identify common features promptly and accurately in both tumors. These features included a Base-Excision Repair mutational signature, a notably high tumor mutational burden, and key driver mutations in somatic tissues. These findings had not been previously reported in similar studies. This report underscores how, in the case of rare tumors, it is possible to comprehensively characterize the mutational landscape of each individual case, potentially opening doors to targeted therapeutic options.
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Adenocarcinoma Sebáceo , Carcinoma Basocelular , Neoplasias de las Glándulas Sebáceas , Neoplasias Cutáneas , Humanos , Neoplasias de las Glándulas Sebáceas/genética , Neoplasias de las Glándulas Sebáceas/patología , Neoplasias de las Glándulas Sebáceas/cirugía , Adenocarcinoma Sebáceo/genética , Adenocarcinoma Sebáceo/patología , Adenocarcinoma Sebáceo/cirugía , Párpados/patología , Reparación del ADNRESUMEN
BACKGROUND: Sebaceous carcinoma (SC) is a rare, potentially recurrent, and life-threatening cutaneous malignancy that can be associated with Muir-Torre syndrome (MTS), a DNA mismatch repair-driven genodermatosis. Earlier studies examining factors associated with recurrence have focused on periocular tumors only. OBJECTIVE: Examine outcomes of SC and identify factors associated with recurrence. MATERIALS AND METHODS: Retrospective study from 2 tertiary care centers. RESULTS: Sixty-seven cases from 63 patients were identified, including 7 cases of MTS and 13 arising in the context of immunosuppression. Fifty-five cases (82.1%) were treated with complete circumferential peripheral and deep margin assessment (CCPDMA) methods. Five recurrences developed during the postoperative period. On univariate analysis, periocular location (odds ratio [OR] 7.6, p = .0410), and lesion size ≥2 cm (OR 9.6, p = .005) were associated with recurrence, whereas CCPDMA (OR 0.052, p = .0006) was inversely associated with recurrence. On multivariate analysis, only lesion size ≥2 cm (OR 9.6, p = .0233) and CCPDMA approaches (OR 0.052, p = .007) were significant. CONCLUSION: Non-complete circumferential peripheral and deep margin assessment methods and large lesion size were independent risk factors predicting recurrence, whereas anatomic subtype and MTS status were not. These findings can assist in identifying SC cases that may benefit from more aggressive treatment and closer surveillance.
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Adenocarcinoma Sebáceo , Síndrome de Muir-Torre , Neoplasias de las Glándulas Sebáceas , Humanos , Estudios Retrospectivos , Estudios de Cohortes , Adenocarcinoma Sebáceo/cirugía , Adenocarcinoma Sebáceo/patología , Síndrome de Muir-Torre/genética , Neoplasias de las Glándulas Sebáceas/cirugía , Neoplasias de las Glándulas Sebáceas/patologíaRESUMEN
BACKGROUND: Mohs micrographic surgery (MMS) for sebaceous carcinoma (SC) may reduce local recurrence rates, but published case series have small cohorts and limited follow-up. Mohs micrographic surgery is particularly suitable for sensitive functional and cosmetic locations, such as the face, because it facilitates tissue conservation using complete peripheral and deep margin assessment before reconstruction. Coordinated care between Mohs and oculoplastic surgeons has not been described. OBJECTIVE: To assess rates of local recurrence and metastasis after MMS of facial SC and to describe coordinated care between Mohs and oculoplastic surgeons. MATERIALS AND METHODS: Retrospective review identified facial SC cases treated with MMS at a single institution from January 2005 to August 2020. Tumor characteristics and outcomes were recorded. Descriptive and predictive analyses were performed. RESULTS: Forty-nine cases were reviewed with a mean follow-up of 51 months. The most common sites were periorbital, infraorbital cheek, and nasal ala. No patients experienced regional recurrence after MMS. One patient with Muir-Torre syndrome developed metastatic recurrence (at 82.9 months). All patients underwent 2-stage reconstruction with dermatology-performed MMS and oculoplastic reconstruction. CONCLUSION: Collaboration between Mohs and oculoplastic surgeons with a tissue-sparing approach of MMS can reduce recurrence and optimize cosmesis and function for central facial SC.
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Adenocarcinoma Sebáceo , Cara , Cirugía de Mohs , Neoplasias de las Glándulas Sebáceas , Humanos , Adenocarcinoma Sebáceo/cirugía , Adenocarcinoma Sebáceo/patología , Recurrencia Local de Neoplasia , Estudios Retrospectivos , Neoplasias de las Glándulas Sebáceas/patología , Neoplasias de las Glándulas Sebáceas/cirugía , Cara/cirugía , Procedimientos de Cirugía Plástica/métodosAsunto(s)
Adenocarcinoma Sebáceo , Quiste Epidérmico , Enfermedades del Cabello , Neoplasias de Anexos y Apéndices de Piel , Neoplasias de las Glándulas Sebáceas , Neoplasias Cutáneas , Adenocarcinoma Sebáceo/diagnóstico , Adenocarcinoma Sebáceo/patología , Adenocarcinoma Sebáceo/cirugía , Quiste Epidérmico/diagnóstico , Quiste Epidérmico/cirugía , Humanos , Neoplasias de Anexos y Apéndices de Piel/patología , Cuero Cabelludo/patología , Neoplasias de las Glándulas Sebáceas/diagnóstico , Neoplasias de las Glándulas Sebáceas/patología , Neoplasias de las Glándulas Sebáceas/cirugía , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/cirugíaRESUMEN
BACKGROUND: Sebaceous carcinoma (SC) is a rare malignant tumour whereby, comprehensive long-term data are scarce. This study aimed to assess the outcome of patients treated with resection for SC. METHODS: Patients treated at four tertiary centres were included. Cumulative incidence curves were calculated for recurrences. RESULTS: A total of 100 patients (57 males, 57%) were included with 103 SCs. The median age was 72 (range, 15-95) years with a median follow-up of 52 (interquartile range [IQR], 24-93) months. Most SCs were located (peri)ocular (49.5%). Of all SCs, 17 locally recurred (16.5%) with a median time to recurrence of 19 (IQR, 8-29) months. The cumulative incidence probability for recurrence was statistically higher for (peri)ocular tumours (p = 0.005), and for positive resection margins (p = 0.001). Two patients presented with lymph node metastases and additional seven patients (8.7%) developed lymph node metastases during follow-up with a median time to metastases of 8 (IQR, 0.5-28) months. Three patients had concurrent in-transit metastases and one patient also developed liver and bone metastases during follow-up. CONCLUSION: SC is a rare, yet locally aggressive tumour. Positive resection margins and (peri)ocular SCs are more frequently associated with local recurrence. SC infrequently presents with locoregional or distant metastases.
Asunto(s)
Adenocarcinoma Sebáceo/secundario , Neoplasias del Ojo/patología , Recurrencia Local de Neoplasia/patología , Neoplasias de las Glándulas Sebáceas/patología , Adenocarcinoma Sebáceo/cirugía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias del Ojo/cirugía , Femenino , Estudios de Seguimiento , Humanos , Metástasis Linfática , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/cirugía , Pronóstico , Estudios Retrospectivos , Neoplasias de las Glándulas Sebáceas/cirugía , Adulto JovenRESUMEN
PURPOSE: To evaluate the effect of direct cell injury of cryotherapy on eyelid sebaceous gland carcinoma cells by an ex vivo cryotherapy experiment. METHODS: It was a prospective interventional case series. Six patients with biopsy-proven nodular sebaceous gland carcinoma were included. After excision of the mass, a thin slice of the mass resembling the thickness of the conjunctiva was shaved off and was oriented over the broad end of a tissue forceps. Cryotherapy was applied to both its anterior and posterior aspects by the triple freeze-thaw technique. The mass was then labeled and sent separately for histopathological evaluation by fixation and staining. RESULTS: A total of six patients with a mean age of 58.2 ± 15.5 years were included. There were four females and two males. The mean duration of the lesion was 21.6 ± 17.51 months. All patients had involvement of the upper eyelid. The patients were clinically staged as T2b (n=2), T1a (n=2), T2c (n=1), and T3a (n=1) respectively. There was no regional lymphadenopathy or metastasis in any of the cases. The experimental cryo-tissue containing the cryo-treated lesion revealed the presence of viable tumor cells (>50%) in all six specimens. CONCLUSION: The direct cell injury caused by cryotherapy may not be sufficient to kill all the residual sebaceous gland carcinoma cells on the tumor bed.
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Adenocarcinoma Sebáceo , Neoplasias de los Párpados , Neoplasias de las Glándulas Sebáceas , Adenocarcinoma Sebáceo/diagnóstico , Adenocarcinoma Sebáceo/cirugía , Adulto , Anciano , Conjuntiva/patología , Crioterapia/efectos adversos , Neoplasias de los Párpados/diagnóstico , Neoplasias de los Párpados/etiología , Neoplasias de los Párpados/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Estudios Retrospectivos , Neoplasias de las Glándulas Sebáceas/diagnóstico , Neoplasias de las Glándulas Sebáceas/etiología , Neoplasias de las Glándulas Sebáceas/cirugía , Glándulas SebáceasRESUMEN
BACKGROUND: Sebaceous carcinoma is an aggressive malignant tumour. To prevent mutilating surgery and improve patient outcomes, early diagnosis and prompt treatment are necessary. When the tumour invades surrounding tissues, treatment may become complex. METHODS: We present a case report illustrating complex resection and reconstruction of a sebaceous carcinoma after initial misdiagnosis. RESULTS: A 74-year-old man with a sebaceous carcinoma to his right upper eyelid had a delay in treatment due to initial misdiagnosis. Upon the correct diagnosis, computed tomography scan showed tumour invasion of the medial rectus muscle and tumour spread to the right parotid gland. An orbital exenteration, partial parotidectomy and selective cervical lymphadenectomy were performed. Frozen section examination showed false-free margins, as additional paraffin embedded sections showed uncomplete tumour resection. Adjuvant radiotherapy was offered to the patient. The treatment was complicated by radio necrosis, necessitating surgical reconstruction by a paramedian forehead flap. Final reconstruction of the right orbit was accomplished by a personalised epithesis. CONCLUSIONS: Sebaceous carcinoma is a tumour that is often misdiagnosed. The aim of this case report is to emphasize the possible consequences of its misdiagnosis. An overview of characteristic clinical findings is provided to help reduce the number of misdiagnoses.
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Adenocarcinoma Sebáceo , Neoplasias de los Párpados , Neoplasias de las Glándulas Sebáceas , Adenocarcinoma Sebáceo/diagnóstico , Adenocarcinoma Sebáceo/patología , Adenocarcinoma Sebáceo/cirugía , Anciano , Errores Diagnósticos , Neoplasias de los Párpados/diagnóstico , Neoplasias de los Párpados/patología , Neoplasias de los Párpados/cirugía , Humanos , Masculino , Neoplasias de las Glándulas Sebáceas/diagnóstico , Neoplasias de las Glándulas Sebáceas/patología , Neoplasias de las Glándulas Sebáceas/cirugía , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: Collision tumors are rare clinical entities that two heterogeneous neoplasms are concurrently adjacent to each other at the same location. The association of a squamous cell carcinoma and a malignant adnexal tumor is even infrequent. CASE PRESENTATION: The case of a 79-year-old woman having a slow-growing and painless tumor on the left lower eyelid was presented. The lesion, about 15 mm in diameter, was nodular, irregular, and yellow-discolored. Histopathologic and immunohistochemical findings disclosed concurrence of sebaceous carcinoma as well as squamous cell carcinoma in one specimen. Wide excision of the tumor with frozen section control and eyelid reconstruction were performed. Oncologic survey revealed no other lesion. At 6-month follow-up, no evidence of recurrence or metastasis was presented. CONCLUSION: Collision tumor composed of sebaceous carcinoma and squamous cell carcinoma in eyelid may be the first case described in the literature. For increasing accuracy of diagnosis and management, a thorough clinical examination and detailed histopathologic analysis, along with multidisciplinary discussion, are prerequisites.
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Adenocarcinoma Sebáceo , Carcinoma de Células Escamosas , Neoplasias de los Párpados , Neoplasias de las Glándulas Sebáceas , Adenocarcinoma Sebáceo/diagnóstico , Adenocarcinoma Sebáceo/patología , Adenocarcinoma Sebáceo/cirugía , Anciano , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/cirugía , Neoplasias de los Párpados/diagnóstico , Neoplasias de los Párpados/patología , Neoplasias de los Párpados/cirugía , Párpados/patología , Párpados/cirugía , Femenino , Humanos , Neoplasias de las Glándulas Sebáceas/diagnóstico , Neoplasias de las Glándulas Sebáceas/patología , Neoplasias de las Glándulas Sebáceas/cirugíaRESUMEN
It took a dermatoscopic examination followed by an e-consultation and shave biopsy to arrive at the diagnosis.
Asunto(s)
Adenocarcinoma Sebáceo/cirugía , Cejas/patología , Neoplasias Cutáneas/cirugía , Biopsia , Diagnóstico Diferencial , Femenino , Humanos , Persona de Mediana EdadAsunto(s)
Adenocarcinoma Sebáceo , Carcinoma de Células de Merkel , Neoplasias de los Párpados , Neoplasias de las Glándulas Sebáceas , Neoplasias Cutáneas , Adenocarcinoma Sebáceo/diagnóstico , Adenocarcinoma Sebáceo/cirugía , Neoplasias de los Párpados/diagnóstico , Párpados , Humanos , Ganglios Linfáticos , Metástasis Linfática , Estudios Retrospectivos , Neoplasias de las Glándulas Sebáceas/diagnósticoRESUMEN
INTRODUCTION: Sebaceous carcinoma is a rare malignant tumor of the sebaceous glands. Sebaceous carcinoma occurs mainly in the head and neck region, rarely in trunk. Case report: We present a case report of 63-year-old patient, operated on for sebaceous carcinoma in the right breast area. The patient underwent radical surgery, removal of the tumor with the skin, subcutaneous tissue, and the large pectoral muscle. The patient is in good clinical condition eight months after the surgery. She is being constantly monitored and so far, there are neither signs of local recurrence nor tumor progression. Conclusion: Patients with rare tumors should be treated comprehensively with subsequent lifelong dispensarisation in specialized centers. Multidisciplinary medical teams are able to eruditely diagnose, recognize, treat and dispense patients.
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Adenocarcinoma Sebáceo , Neoplasias de las Glándulas Sebáceas , Neoplasias Cutáneas , Adenocarcinoma Sebáceo/diagnóstico , Adenocarcinoma Sebáceo/patología , Adenocarcinoma Sebáceo/cirugía , Femenino , Humanos , Persona de Mediana Edad , Neoplasias de las Glándulas Sebáceas/diagnóstico , Neoplasias de las Glándulas Sebáceas/patología , Neoplasias de las Glándulas Sebáceas/cirugía , Neoplasias Cutáneas/patologíaRESUMEN
In this report, we discussed the progression from the initial presentation until surgical intervention, clinical course, and devastating outcome of a neglected giant sebaceous gland carcinoma of the eyelid in a poorly compliant elderly patient. A 79-year-old woman was referred for treatment of a giant ulcero-nodular lesion in the right upper eyelid. Nine months before, an orange lesion arising from the tarsal conjunctiva in the upper eyelid was observed in her examination undergone in the healthcare center where she initially presented, and the cornea appeared transparent. Surgical excision was recommended, which she declined. The examination three months before in the same center revealed that the lesion invaded the globe and anterior segment architecture could not be visualized. She was then recommended surgical removal of the eyeball, which she also refused. Radiological imaging demonstrated a 33x35 mm mass lesion in the superior lateral of orbit with exophytic growth and invasion of the globe and no systemic metastases were found. Total orbital exenteration surgery was immediately planned and performed. Histopathological examination revealed sebaceous gland carcinoma. Elderly patients with poor compliance should discuss their condition with a psychiatrist and should be managed by a multidisciplinary approach. This way, patients with eyelid malignancies can be encouraged to undergo surgery and receive early treatment, decreasing the need for exenteration, improving clinical outcomes, and reducing the risk of morbidity and mortality.