ePoster listing and sessions

Topic: ESOPRS 2021 ePoster sessions
Time: Sep 17, 2021 16:00 Amsterdam, Berlin, Rome, Stockholm, Vienna, 15:00 London

 

 

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Sebaceous gland carcinoma in situ – a rare entity

Author: Natasa Mihailovic
ePoster Number: 251


Purpose

We report the case of a 76-year-old female patient who presented with a tumor of the right lower eyelid margin (Figure). The lesion was only slightly prominent, not painful and did not itch or bleed. Slit lamp examination revealed a chronic blepharitis and meibomian gland dysfunction. The lesion showed slight hyperkeratosis and pigmentation, but no madarosis. The patient had noticed first symptoms 4-5 months ago. She had tried antibiotic and steroid ointments without success. Since we were not sure about the origin of the lesion, we recommended a biopsy in shaving technique.


Methods

Initially, the histopathological finding of the sample biopsy revealed a squamous cell carcinoma (SCC) in situ. As we now had evidence of malignancy, we performed a total excision of the tumor with a safety margin of 3mm (Figure) and send it to further histopathological evaluation including immunohistochemistry. Immunohistochemically, the cell population was positive for CK7 and BerEP4 as well as partially for p40, also androgen receptors were expressed focally.


Results

Overall, the immunohistochemical findings now led to a correction of the initial diagnosis of a SCC to an intraepithelial (in situ) sebaceous gland carcinoma (SGC). In the following, we performed an eyelid margin repair with a periostal flap and free dermal graft (Figure). A follow-up of two years showed no hint of recurrence of the carcinoma.


Conclusion

Ocular SGC is an uncommon, aggressive tumor arising from the Meibomian, Zeis, or sebaceous glands in the caruncle or eyelashes. Globally, the overall incidence of SGC is increasing making it the third most common eyelid malignancy after basal cell carcinoma (BCC) and SCC. The mainstay of treatment of ocular SGC is wide surgical resection followed by eyelid reconstruction. Our case shows a sebaceous carcinoma in situ, an extremely rare and very ill-defined entity. We suggest that when an ophthalmologist removes a suspicious lesion and receives a diagnosis of SCC (in situ), he or she should raise the possibility of SCG and suggest reexamination, lipid stains, and perhaps additional pathology consultations.


Additional Authors

First nameLast nameBase Hospital / Institution
HannahSchattenDepartment of Ophthalmology, University of Muenster Medical Center, Münster
Ralph-LaurentMertéDepartment of Ophthalmology, University of Muenster Medical Center, Münster
SandraElgesUniversity Hospital Muenster, Gerhard-Domagk-Institute for Pathology, Muenster, Germany.

Abstract ID: 21-148