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.
Asunto(s)
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 TratamientoAsunto(s)
Anticuerpos Monoclonales Humanizados , Antineoplásicos Inmunológicos , Neoplasias de las Glándulas Sebáceas , Humanos , Anticuerpos Monoclonales Humanizados/uso terapéutico , Neoplasias de las Glándulas Sebáceas/tratamiento farmacológico , Neoplasias de las Glándulas Sebáceas/patología , Antineoplásicos Inmunológicos/uso terapéutico , Masculino , Adenocarcinoma Sebáceo/tratamiento farmacológico , Adenocarcinoma Sebáceo/secundario , Adenocarcinoma Sebáceo/patología , Anciano , FemeninoAsunto(s)
Neoplasias de los Párpados , Neoplasias de las Glándulas Sebáceas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adenocarcinoma Sebáceo/diagnóstico , Adenocarcinoma Sebáceo/inducido químicamente , Adenocarcinoma Sebáceo/tratamiento farmacológico , Neoplasias de los Párpados/tratamiento farmacológico , Neoplasias de los Párpados/diagnóstico , Neoplasias de las Glándulas Sebáceas/diagnóstico , Neoplasias de las Glándulas Sebáceas/inducido químicamente , Neoplasias de las Glándulas Sebáceas/tratamiento farmacológico , AdultoRESUMEN
BACKGROUND Sebaceous carcinoma is a rare malignant tumor of the skin adnexa. While surgical resection is a treatment of choice in localized disease, frequent recurrence and distant metastasis make treatment difficult. Moreover, due to its rarity, optimal systemic treatment has not been determined. CASE REPORT A 59-year-old female presented with disseminated subcutaneous nodules. Past history indicated she received repeated surgery, radiation therapy, and fluorouracil-based systemic chemotherapy for recurrent sebaceous carcinoma. Following a subcutaneous nodule biopsy, histopathologic examination confirmed recurrent metastasis of sebaceous carcinoma. Because there was no established regimen as salvage chemotherapy, we decided to administer paclitaxel plus Adriamycin as a combination regimen after a thorough search of previous reports on PubMed. After the patient received 6 cycles of chemotherapy, all masses dramatically regressed. Unfortunately, several new lesions appeared 3 months after cessation of chemotherapy. Therefore, she was treated with anti-HGF antibody through a clinical trial. After that, she received nivolumab. But treatment with all the new agents did not show any response. Furthermore, her disease progressed rapidly. We re-challenged with the paclitaxel and Adriamycin regimen, 2 cycles of chemotherapy, and the follow-up positron emission tomography - computed tomography revealed marked decrement of multiple metastatic nodules. CONCLUSIONS Although several clinical reports have shown the effectiveness of fluorouracil, especially 5-fluorouracil-based chemotherapy, there has been a paucity of reports on other chemotherapeutic agents. We report a case of metastatic sebaceous carcinoma which showed favorable response to non-fluorouracil-based chemotherapy.
Asunto(s)
Adenocarcinoma Sebáceo/secundario , Doxorrubicina/uso terapéutico , Paclitaxel/uso terapéutico , Neoplasias de las Glándulas Sebáceas/patología , Neoplasias Cutáneas/secundario , Adenocarcinoma Sebáceo/diagnóstico , Adenocarcinoma Sebáceo/tratamiento farmacológico , Antibióticos Antineoplásicos/uso terapéutico , Antineoplásicos Fitogénicos/uso terapéutico , Quimioterapia Combinada , Femenino , Fluorouracilo , Humanos , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Tomografía Computarizada por Tomografía de Emisión de Positrones , Neoplasias de las Glándulas Sebáceas/tratamiento farmacológico , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/tratamiento farmacológico , Resultado del TratamientoRESUMEN
A 72-year-old Caucasian woman who had recurrent sebaceous carcinoma of the right orbit with bilateral cervical lymph node involvement 24 months after orbital exenteration was treated with carboplatin (area under the curve of 5) and pembrolizumab (2 mg/kg) for 6 cycles, followed by maintenance pembrolizumab. She obtained a complete pathological remission and remains free of local, regional, and systemic disease at 15 months.
Asunto(s)
Adenocarcinoma Sebáceo/tratamiento farmacológico , Anticuerpos Monoclonales Humanizados/uso terapéutico , Antineoplásicos Inmunológicos/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carboplatino/uso terapéutico , Recurrencia Local de Neoplasia/tratamiento farmacológico , Neoplasias de las Glándulas Sebáceas/tratamiento farmacológico , Adenocarcinoma Sebáceo/cirugía , Anciano , Femenino , Humanos , Quimioterapia de Inducción/métodos , Quimioterapia de Mantención/métodos , Neoplasias de las Glándulas Sebáceas/cirugía , Resultado del TratamientoRESUMEN
PURPOSE: To report the efficacy of neoadjuvant systemic chemotherapy in the management of eyelid sebaceous gland carcinoma (SGC). METHODS: Retrospective study of 10 patients that received neoadjuvant systemic chemotherapy (Cisplatin/Carboplatin and 5-Fluorouracil) for eyelid SGC. RESULTS: The mean age at presentation of eyelid SGC was 58 years (median, 55 years; range, 45 to 72 years). There were 6 females and 4 males. The mean tumor basal diameter was 36 mm (median, 31 mm, range, 20 to 65 mm), with orbital tumor extension in 9 cases. On the basis of TNM Classification, the tumors were classified as T3 (n = 10), N1 (n = 6), and M1 (n = 2). The mean number of cycles of neoadjuvant systemic chemotherapy per patient was 3 (median, 3; range, 3 to 4). The mean percentage reduction of tumor basal diameter after neoadjuvant chemotherapy was 74% (median, 80%; range, 30% to 100%). None of them had any major systemic side-effects of neoadjuvant chemotherapy. Postchemotherapy, surgical treatment for residual tumor was performed in 7 cases. Five cases underwent excision biopsy and 2 cases with residual orbital component underwent eyelid-sparing orbital exenteration. No tumor recurrence was noted in any of the 7 cases at a mean follow-up period of 18 months (median, 14 months; range, 3 to 63 months). One patient died due to systemic metastasis. CONCLUSION: Neoadjuvant systemic chemotherapy is effective and safe in the management of eyelid sebaceous gland carcinoma.
Asunto(s)
Adenocarcinoma Sebáceo/tratamiento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de los Párpados/tratamiento farmacológico , Neoplasias de las Glándulas Sebáceas/tratamiento farmacológico , Adenocarcinoma Sebáceo/patología , Anciano , Carboplatino/administración & dosificación , Cisplatino/administración & dosificación , Neoplasias de los Párpados/patología , Femenino , Fluorouracilo/administración & dosificación , Humanos , Masculino , Persona de Mediana Edad , Terapia Neoadyuvante , Estadificación de Neoplasias , Estudios Retrospectivos , Neoplasias de las Glándulas Sebáceas/patologíaRESUMEN
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.
Asunto(s)
Adenocarcinoma Sebáceo/tratamiento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Recurrencia Local de Neoplasia/tratamiento farmacológico , Cuidados Paliativos/métodos , Neoplasias de las Glándulas Sebáceas/tratamiento farmacológico , Adenocarcinoma Sebáceo/patología , Anciano , Asia , Cisplatino/administración & dosificación , Cisplatino/efectos adversos , Femenino , Fluorouracilo/administración & dosificación , Fluorouracilo/efectos adversos , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/patología , Neoplasias de las Glándulas Sebáceas/patologíaRESUMEN
PURPOSE: To observe the curative effect of Xeloda in meibomian gland carcinoma. METHODS: We treated a 53-year-old woman, who had recrudescent meibomian gland carcinoma, with Xeloda. RESULTS: The mass was much smaller with decreased amount of overflow pus after 4 cycles of chemotherapy with Xeloda. CONCLUSIONS: Xeloda played a significant role in treating recrudescent meibomian gland carcinoma in this patient.
Asunto(s)
Adenocarcinoma Sebáceo/tratamiento farmacológico , Antimetabolitos Antineoplásicos/uso terapéutico , Desoxicitidina/análogos & derivados , Neoplasias de los Párpados/tratamiento farmacológico , Fluorouracilo/análogos & derivados , Glándulas Tarsales/efectos de los fármacos , Recurrencia Local de Neoplasia/tratamiento farmacológico , Adenocarcinoma Sebáceo/diagnóstico por imagen , Adenocarcinoma Sebáceo/secundario , Capecitabina , Desoxicitidina/uso terapéutico , Neoplasias de los Párpados/diagnóstico por imagen , Neoplasias de los Párpados/patología , Femenino , Fluorouracilo/uso terapéutico , Humanos , Metástasis Linfática , Glándulas Tarsales/diagnóstico por imagen , Glándulas Tarsales/patología , Persona de Mediana Edad , Recurrencia Local de Neoplasia/diagnóstico por imagen , Recurrencia Local de Neoplasia/patología , Profármacos , Tomografía Computarizada por Rayos X , Resultado del TratamientoAsunto(s)
Adenocarcinoma Sebáceo/tratamiento farmacológico , Cisplatino/uso terapéutico , Neoplasias de los Párpados/tratamiento farmacológico , Fluorouracilo/uso terapéutico , Neoplasias Orbitales/tratamiento farmacológico , Adenocarcinoma Sebáceo/diagnóstico por imagen , Adenocarcinoma Sebáceo/patología , Evisceración del Ojo , Neoplasias de los Párpados/diagnóstico por imagen , Neoplasias de los Párpados/patología , Humanos , Masculino , Persona de Mediana Edad , Terapia Neoadyuvante , Invasividad Neoplásica , Procedimientos Quirúrgicos Oftalmológicos , Neoplasias Orbitales/diagnóstico por imagen , Neoplasias Orbitales/patología , Radioterapia Adyuvante , Tomografía Computarizada por Rayos XAsunto(s)
Adenocarcinoma Sebáceo/patología , Enfermedades de la Conjuntiva/patología , Enfermedades de la Córnea/patología , Neoplasias del Ojo/patología , Neoplasias de los Párpados/patología , Enfermedad de Paget Extramamaria/patología , Neoplasias de las Glándulas Sebáceas/patología , Adenocarcinoma Sebáceo/tratamiento farmacológico , Administración Tópica , Antibióticos Antineoplásicos/uso terapéutico , Biopsia , Enfermedades de la Conjuntiva/tratamiento farmacológico , Enfermedades de la Córnea/tratamiento farmacológico , Neoplasias del Ojo/tratamiento farmacológico , Neoplasias de los Párpados/tratamiento farmacológico , Femenino , Humanos , Persona de Mediana Edad , Mitomicina/uso terapéutico , Invasividad Neoplásica , Soluciones Oftálmicas , Enfermedad de Paget Extramamaria/tratamiento farmacológico , Neoplasias de las Glándulas Sebáceas/tratamiento farmacológico , Agudeza Visual/fisiologíaRESUMEN
A 35-year-old man presented with a recurrent temporal conjunctival mass (25 × 12 mm) involving about six-clock hours of the limbus in the left eye. The mass encroached onto the temporal half of cornea and showed surface keratin, large intrinsic and feeder vessels. It infiltrated the deep corneal stroma. There were no cells in the anterior chamber. Ultrasound biomicroscopy confirmed infiltration of deep corneal stroma without intraocular invasion. Surgery involved excision of the conjunctival component with 4-mm margin, lamellar sclerectomy and a penetrating sclerokeratoplasty with 3 mm of healthy corneal margin. Cryotherapy (double-freeze-thaw) was done to the conjunctival margins. Histopathology showed it to be invasive sebaceous cell carcinoma. A thin layer of deep corneal stroma and all conjunctival margins were uninvolved. At thirty-six weeks after treatment the left eye recorded a visual acuity of finger counting at 1 meter distance and no recurrence.
Asunto(s)
Adenocarcinoma Sebáceo/tratamiento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de los Párpados/tratamiento farmacológico , Recurrencia Local de Neoplasia/tratamiento farmacológico , Neoplasias Orbitales/tratamiento farmacológico , Neoplasias de las Glándulas Sebáceas/tratamiento farmacológico , Adenocarcinoma Sebáceo/secundario , Cisplatino/administración & dosificación , Neoplasias de los Párpados/patología , Fluorouracilo/administración & dosificación , Humanos , Escisión del Ganglio Linfático , Metástasis Linfática , Masculino , Persona de Mediana Edad , Terapia Neoadyuvante , Invasividad Neoplásica , Recurrencia Local de Neoplasia/patología , Neoplasias Orbitales/patología , Neoplasias de las Glándulas Sebáceas/patología , Tomografía Computarizada por Rayos XRESUMEN
PURPOSE: To report on the use of Mitomycin-C as adjuvant therapy to excision and cryotherapy in patients with sebaceous gland carcinoma (SGC) in high-risk locations. DESIGN: Retrospective, consecutive, case series. PARTICIPANTS: Three patients with SGC of the upper palpebral conjunctiva or caruncle, but without clinical pagetoid spread. METHODS: Following excision and double freeze-thaw cryotherapy, patients with histology demonstrating SGC of the ocular surface were treated with topical Mitomycin-C (0.04%). Follow-up was conducted over an average of 30 months (range: 24-37 months). MAIN OUTCOME MEASURES: Postoperative evidence of local recurrence, lymph node or distant organ metastasis. RESULTS: No patients had evidence of local recurrence or systemic disease. CONCLUSIONS: Wide surgical excision with cryotherapy is the basis of treatment of SGC without pagetoid spread. The use of Mitomycin-C as adjuvant therapy remains controversial, although there is some rationale for its use in high-risk situations.
Asunto(s)
Adenocarcinoma Sebáceo/terapia , Antibióticos Antineoplásicos/uso terapéutico , Neoplasias de la Conjuntiva/terapia , Mitomicina/uso terapéutico , Neoplasias de las Glándulas Sebáceas/terapia , Adenocarcinoma Sebáceo/tratamiento farmacológico , Adenocarcinoma Sebáceo/cirugía , Anciano , Anciano de 80 o más Años , Quimioterapia Adyuvante , Neoplasias de la Conjuntiva/tratamiento farmacológico , Neoplasias de la Conjuntiva/cirugía , Crioterapia , Femenino , Humanos , Masculino , Estudios Retrospectivos , Neoplasias de las Glándulas Sebáceas/tratamiento farmacológico , Neoplasias de las Glándulas Sebáceas/cirugíaRESUMEN
Intraoral sebaceous carcinoma (SC) is a rare tumour in the oral cavity thought to arise from malignant transformation of oral sebaceous glands. To our knowledge, only six cases of intraoral SC have been reported in the English language literature. The purpose of the present article is to report an additional case and review the literature.
Asunto(s)
Adenocarcinoma Sebáceo/diagnóstico , Neoplasias de la Boca/diagnóstico , Neoplasias de las Glándulas Sebáceas/diagnóstico , Adenocarcinoma Sebáceo/tratamiento farmacológico , Biopsia , Terapia Combinada , Diagnóstico Diferencial , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de la Boca/terapia , Radiografía Panorámica , Neoplasias de las Glándulas Sebáceas/terapia , Tomografía Computarizada por Rayos XRESUMEN
AIM: To determine the complications associated with mitomycin C (MMC) in the treatment of ocular surface neoplasia. METHODS: A retrospective and consecutive study of 100 eyes in 91 patients with ocular surface neoplasia treated with MMC in a single centre between November 1998 and January 2005. Outcome measures included complications of MMC and the treatment required for these complications. RESULTS: One to three 7 day cycles of topical MMC 0.04% four times a day were given to 59 eyes with localised corneal-conjunctival intraepithelial neoplasia (CIN), 19 eyes with diffuse CIN, six eyes with recurrent CIN, one eye with ocular surface squamous cell carcinoma, three eyes with primary acquired melanosis (PAM) with atypia, nine eyes with conjunctival malignant melanoma (MM), two eyes with sebaceous carcinoma with pagetoid spread, and one eye with recurrent atypical fibroxanthoma. Nine patients had bilateral CIN. 31 (34%) cases developed an allergic reaction to MMC and 14 (14%) eyes had epiphora secondary to punctal stenosis at a mean follow up period of 26.5 months. CONCLUSION: In the largest study looking at complications of topical MMC in the treatment of ocular surface neoplasia, allergic reaction and punctal stenosis are relatively common. Serious complications were not observed suggesting the safe use of MMC in mid-term follow up.
Asunto(s)
Antibióticos Antineoplásicos/efectos adversos , Hipersensibilidad a las Drogas/etiología , Neoplasias del Ojo/tratamiento farmacológico , Mitomicina/efectos adversos , Adenocarcinoma Sebáceo/tratamiento farmacológico , Antibióticos Antineoplásicos/uso terapéutico , Carcinoma in Situ/tratamiento farmacológico , Carcinoma de Células Escamosas/tratamiento farmacológico , Neoplasias de la Conjuntiva/tratamiento farmacológico , Enfermedades de la Córnea/tratamiento farmacológico , Femenino , Estudios de Seguimiento , Histiocitoma Fibroso Benigno/tratamiento farmacológico , Humanos , Enfermedades del Aparato Lagrimal/inducido químicamente , Obstrucción del Conducto Lagrimal/inducido químicamente , Masculino , Melanoma/tratamiento farmacológico , Melanosis/tratamiento farmacológico , Mitomicina/uso terapéutico , Estudios RetrospectivosRESUMEN
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.
Asunto(s)
Adenocarcinoma Sebáceo/tratamiento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de los Párpados/tratamiento farmacológico , Neoplasias Orbitales/tratamiento farmacológico , Neoplasias de las Glándulas Sebáceas/tratamiento farmacológico , Adenocarcinoma Sebáceo/diagnóstico por imagen , Adenocarcinoma Sebáceo/secundario , Carboplatino/administración & dosificación , Neoplasias de los Párpados/diagnóstico por imagen , Neoplasias de los Párpados/patología , Femenino , Fluorouracilo/administración & dosificación , Humanos , Ganglios Linfáticos/patología , Metástasis Linfática , Persona de Mediana Edad , Terapia Neoadyuvante , Recurrencia Local de Neoplasia , Neoplasias Orbitales/diagnóstico por imagen , Neoplasias Orbitales/secundario , Neoplasias de las Glándulas Sebáceas/diagnóstico por imagen , Neoplasias de las Glándulas Sebáceas/patología , Tomografía Computarizada por Rayos XRESUMEN
PURPOSE: To evaluate the efficacy of topical mitomycin-C for pagetoid invasion of the conjunctiva by sebaceous gland carcinoma. DESIGN: Prospective noncomparative consecutive interventional case series. INTERVENTION: All patients received topical 0.04% mitomycin-C four times daily for 1 week followed by 1 week off medication. The treatment cycles were repeated until resolution of the conjunctival malignancy was clinically evident. PARTICIPANTS: Four patients with histopathologically proven intraepithelial (pagetoid) invasion of the conjunctiva by sebaceous gland carcinoma were managed with this regimen. RESULTS: The mean patient age was 78 years. Before treatment, the main tumor site included the upper eyelid in two cases and the lower eyelid in two cases. Previous resection of the tumor had been performed elsewhere in three cases over the prior 6 years. At the time of our examination, map biopsies confirmed pagetoid invasion involving 25% to 90% of the conjunctival surface, with bulbar, forniceal, and tarsal conjunctival involvement in all four cases and corneal extension in one case. There was no evidence of deep tumor within the conjunctival stroma or tarsus in any case. After treatment, medication intolerance and early discontinuation occurred in one patient, and continued tumor progression was documented. Of the remaining three patients, chemotherapy was used for a mean of four cycles with complete resolution of the pagetoid invasion, confirmed histopathologically in two cases, and without recurrence in all three cases over 12 months (mean) follow-up. The medication caused moderate temporary local irritation but no serious intraocular or extraocular complications. CONCLUSIONS: Preliminary evidence suggests that topical mitomycin-C is effective treatment for pagetoid invasion of the conjunctiva by sebaceous gland carcinoma. Longer follow-up is necessary to assess the duration of tumor control.
Asunto(s)
Adenocarcinoma Sebáceo/tratamiento farmacológico , Antibióticos Antineoplásicos/uso terapéutico , Neoplasias de la Conjuntiva/tratamiento farmacológico , Neoplasias de los Párpados/tratamiento farmacológico , Mitomicina/uso terapéutico , Neoplasias de las Glándulas Sebáceas/tratamiento farmacológico , Adenocarcinoma Sebáceo/patología , Administración Tópica , Anciano , Anciano de 80 o más Años , Neoplasias de la Conjuntiva/patología , Neoplasias de los Párpados/patología , Femenino , Humanos , Masculino , Invasividad Neoplásica , Estudios Prospectivos , Neoplasias de las Glándulas Sebáceas/patologíaRESUMEN
A 47-year-old man was admitted to Shinshu University Hospital in 1992 because of cough and chest abnormal shadow. In 1987, he had an operation for Meibomian gland carcinoma of his right lower eyelid, and also received radiotherapy. His chest X-ray film on admission showed tumor shadows in the bilateral upper lung fields. The chest CT scan showed tumors in the right S1 and the left S3. Bronchofiberscopic findings demonstrated stenosis of the right upper bronchus and an endobronchial mass occluding the left B3. A biopsy specimen of the endobronchial mass revealed sebaceous carcinoma, which was identical with that of the resected eyelid tumor. He received two courses of chemotherapy in a combination of CDDP 75 mg/m2 and ADM 50 mg/m2. The tumors on chest X-ray and CT scan became small by the chemotherapy. Bronchofiberscopy after the chemotherapy also revealed that the stenosis of the right upper bronchus improved and the endobronchial mass in the left B3 had disappeared. He died 8 months after initial chemotherapy with a response duration of 7 months.