RESUMO
Sebaceous carcinoma is a malignancy arising in the periocular region that can lead to blindness and tumor-related metastases. This study is a review of published literature and personal experience. This malignancy can arise from the sebaceous units in the tarsus (meibomian glands), in association with the cilia (Zeis glands), in the brow, and in the caruncle. There is a tendency for diffuse intraepithelial growth (pagetoid spread) that can be clinically invisible. Detection before lymph node metastasis is critical. This malignancy often masquerades as chronic unilateral conjunctivitis or blepharitis, typically in older patients. Management includes a 2-step approach with step 1 focused on eyelid and conjunctival map biopsies to determine the full extent of solid deep tumor and pagetoid spread. After complete review of all biopsies, step 2 is performed using local resection for all deep tumor, cryotherapy to pagetoid disease, and reconstruction. In most cases, the posterior lamella of eyelid is sacrificed with tumor removal, whereas the anterior lamella of the eyelid can be saved. After removal and cryotherapy, immediate reconstruction, using clean instruments, with buccal membrane graft for the posterior lamella and skin flap for the anterior lamella, is developed. For persistent or recurrent pagetoid disease, cryotherapy, topical mitomycin C, or plaque radiotherapy is provided. Exenteration is sometimes necessary. Sebaceous carcinoma, if detected early, can be managed with carefully planned map biopsy to determine tumor extent, followed by local resection, cryotherapy, and eyelid reconstruction. Orbital exenteration is occasionally necessary.
Assuntos
Adenocarcinoma Sebáceo , Neoplasias da Túnica Conjuntiva , Neoplasias Palpebrais , Neoplasias das Glândulas Sebáceas , Adenocarcinoma Sebáceo/patologia , Adenocarcinoma Sebáceo/terapia , Antineoplásicos/uso terapêutico , Braquiterapia/métodos , Neoplasias da Túnica Conjuntiva/patologia , Neoplasias da Túnica Conjuntiva/terapia , Criocirurgia/métodos , Crioterapia/métodos , Diagnóstico Diferencial , Neoplasias Palpebrais/patologia , Neoplasias Palpebrais/terapia , Humanos , Mitomicina/uso terapêutico , Recidiva Local de Neoplasia , Neoplasias das Glândulas Sebáceas/patologia , Neoplasias das Glândulas Sebáceas/terapiaRESUMO
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.
Assuntos
Adenocarcinoma Sebáceo/diagnóstico , Neoplasias Bucais/diagnóstico , Neoplasias das Glândulas Sebáceas/diagnóstico , Adenocarcinoma Sebáceo/tratamento farmacológico , Biópsia , Terapia Combinada , Diagnóstico Diferencial , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/terapia , Radiografia Panorâmica , Neoplasias das Glândulas Sebáceas/terapia , Tomografia Computadorizada por Raios XRESUMO
Sebaceous gland carcinoma is considered a relatively rare tumor and represents approximately 1 and 5% of all eyelid tumors. These tumors usually arise in the Meibomian glands of tarsus, in the Zeis glands, and the sebaceous glands of caruncle or eyebrow. In some instances it had multicentric origin, while in other cases the initial location was unable to be determined. It occurs more frequently in women than in men and presentation age varies from 50 to 90 years. Clinical diagnosis is difficult because is can be confused with chalazion, blepharoconjunctivitis, conjunctivitis, and basocellular carcinoma. Sebaceous gland carcinoma could go unnoticed; thus, it is necessary to carry out excision of conjunctiva as well as to inform the pathologist of the possibility of malignancy, because pagetoide spread can be easily incorrectly interpreted or not observed even by expert pathologists (up to 50%). Five-years mortality has been estimated at 30% due delayed diagnosis and treatment. The present work intends to describe incidence, and clinical and histopathologic presentation of sebaceous gland carcinoma during the last 40 years at the Dr. Luis Sanchez Bulnes Hospital, Association to Prevent Blindness in Mexico, as well as to review treatment modalities forecast for this entity.