Purpose

Periocular sebaceous carcinoma is a rare malignancy with reported nodal metastasis rates ranging from 4% to 21%. Mohs micrographic surgery (MMS) is often the standard of care for local tumor control, while sentinel lymph node biopsy (SLNB) is variably employed for staging. However, the clinical behavior of periocular sebaceous carcinoma treated with MMS and the diagnostic yield of SLNB remain incompletely defined.

This study aimed to characterize tumor behavior, surgical outcomes, and SLNB utilization in patients with periocular sebaceous carcinoma treated with MMS.

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Methods

Adult patients with biopsy-proven periocular sebaceous carcinoma were identified from a prospectively maintained database (2005-2025). Demographic, clinical, and tumor characteristics were collected. Outcomes of interest included tumor clearance, local recurrence, regional nodal metastasis, distant metastasis, and SLNB results. Continuous variables were summarized using median and interquartile range (IQR), and categorical variables as counts and percentages. Patients with <90 days of follow-up were excluded.

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Results

A total of 17 patients with periocular sebaceous carcinoma were identified (median age, 67.0 years; IQR, 59.0-79.5; 58.8% male). Tumors most commonly involved the eyelid and canthal region (64.7%), with a median thickness of 2.0 mm (IQR 1.0-3.0). Ulceration and perineural invasion were present in 3 (17.6%) and 2 (11.8%) patients, respectively, with no lymphovascular invasion observed. MMS achieved tumor clearance in 15 patients (88.2%), with a median of 1 surgical stage (IQR 1.0-3.0). Local recurrence occurred in 1 patient (5.9%), and no cases of regional nodal or distant metastasis were identified. SLNB was performed in 5 patients (29.4%), with no positive nodes identified.

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Conclusion

Periocular sebaceous carcinoma treated with MMS demonstrated high rates of tumor clearance and low rates of recurrence and metastasis in this cohort. SLNB identified no nodal metastases, suggesting a potentially limited diagnostic yield in this population.

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Additional Authors

First name	Last name	Base Hospital / Institution
Ana	Montoya Zuluaga	Drexel University College of Medicine
Lauren	Staelin	University of Pennsylvania
Kiara	Corcoran Ruiz	Scheie Eye Institute, University of Pennsylvania
Bridget	Loja Patino	University of Pennsylvania Perelman School of Medicine
Jocelyn	He	Department of Ophthalmology, University of Pennsylvania
Gui-shuang	Ying	Department of Ophthalmology, University of Pennsylvania
César	Briceño	Scheie Eye Institute, University of Pennsylvania

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