Abstract Listings 2026

Purpose

To report a case of a sebaceous gland carcinoma (SGC) of the upper eyelid initially presenting as a recurrent chalazion, emphasizing the challenges in early diagnosis, successful surgical reconstruction, and the management of subsequent regional lymph node metastasis.

Methods

A 70-year-old male patient underwent incision and curettage twice in December 2025 for a presumed recurrent chalazion of the left upper eyelid. Due to the recurrence on same spot, the second specimen was sent for histopathological diagnosis (PHD), which revealed a sebaceous carcinoma.

Results

The patient subsequently underwent a wide local excision of the upper eyelid with frozen-section controlled tumor-free margins. The resulting defect was reconstructed using a local advancement flap facilitated by a lateral cantholysis (release of the superior crus of the lateral canthal ligament), achieving excellent postoperative eyelid function and blinking mechanism.However, follow-up neck ultrasonography detected a suspicious left cervical lymph node, confirmed cytologically as a metastasis. Following a multidisciplinary oncology board review, the patient was transitioned to an ENT/Head and Neck protocol. He underwent a total left parotidectomy, selective neck dissection, and defect reconstruction utilizing a free graft. The patient remains under close multidisciplinary follow-up.

Conclusion

Sebaceous carcinoma is a notorious “masquerader” that requires a high index of suspicion in cases of atypical or recurrent chalazia. Prompt histological evaluation is mandatory. While local control can be successfully achieved with wide excision and meticulous oculoplastic reconstruction, aggressive regional staging (including neck imaging) is crucial due to the high propensity for lymphatic spread, requiring tight coordination with head and neck oncology teams.

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