Medial Canthal Sebaceous Gland Carcinoma: A 14-Year Case Series
Author: Mumta Kanda
Base Hospital / Institution: Moorfields Eye Hospital, London
ePoster presentation
Abstract ID: 25-294
Purpose
Medial canthal sebaceous gland carcinoma (SGC) presents challenges due to proximity to the lacrimal outflow system and complex regional anatomy. Medial canthal site has been associated with risk of metastasis and mortality, yet data on such cases remain limited. We present a case series from a UK tertiary centre.
Methods
Retrospective consecutive case series of histologically confirmed medial canthal SGC at Moorfields Eye Hospital from 2010–2024.
Results
15 patients were included (mean age 74 (49-91) years; 60% female). Mean symptom duration was 18.5 (4-84) months. Initial misdiagnosis as squamous cell carcinoma occurred in 27% due to the absence of immunohistochemical analysis at referring centres. Poor differentiation was noted in 67% of cases and pagetoid spread in 60%. Primary treatment comprised wide local excision (47%), Mohs micrographic surgery (13%), and orbital exenteration (OE, 33%). Adjuvant topical mitomycin-C was used in 27%. Surgical clearance of tumour required more than one resection in 67% of cases having globe-preserving surgery. Lacrimal outflow invasion (1 canaliculus; 1 canaliculi and lacrimal sac) was found in 13%, only on OE histology. Both were poorly differentiated with pagetoid spread. Recurrence affected 1 patient (7%), requiring OE. There were no metastases or disease-related deaths over mean follow-up of 59 (5-149) months.
Conclusion
In medial canthal SGC, there is risk of lacrimal outflow invasion that may not be evident clinically or radiologically. Pre-operative history, examination, and MRI head/orbits should assess for lacrimal outflow involvement. Histology with immunohistochemistry by an ophthalmic pathologist is essential; in OE specimens, the lacrimal sac should be analysed to identify invasion. Most patients required more than one surgery to achieve clear margins, and 40% required OE, illustrating the difficulty of achieving complete excision in this anatomical location. With timely multidisciplinary management in a specialist tertiary centre, we demonstrate positive outcomes with low recurrence and no metastases or death from disease.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Allan | Nghiem | Moorfields Eye Hospital, London |
| Tarang | Gupta | Moorfields Eye Hospital |
| Claire | Daniel | Moorfields Eye Hospital |
