An Analysis of Conjunctival Map Biopsies in Sebaceous Carcinoma

McConnell, Lindsay K.; Syed, Nasreen A.; Zimmerman, M. Bridget; Carter, Keith D.; Nerad, Jeffery A.; Allen, Richard C.; Shriver, Erin M.

doi:10.1097/iop.0000000000000616

Cited by 23 publications

(13 citation statements)

References 11 publications

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“…Permanent sections are recommended [13]. A recent publication by McConnell indicates that the pattern and location of the primary tumour do not correlate to a possible intraepithelial spread and therefore standardized mapping biopsies are always recommended [21]. Contrary to these recommendations, in our study 27% of respondents never used and 54 % occasionally used conjunctival mapping biopsies.…”

Section: Preoperative Work-upcontrasting

confidence: 60%

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Nordic treatment practices survey and consensus for treatment of eyelid sebaceous carcinoma

et al. 2020

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Background: The purpose was to describe the Nordic treatment practices and to reach a Nordic consensus for the treatment of sebaceous eyelid carcinoma. Methods: The treatment practices data was collected by a questionnaire with 37 questions to the Nordic oculoplastic surgeons and analyzed. A PubMed MEDLINE database search was done to gather data on the published treatment practices and recommendations. A working group that consisted of in minimum one senior consultant from each leading Nordic University Eye Hospital was assigned. A structured interactive method was used to establish the consensus. Results: Twenty-four doctors responded to the questionnaire. 23/24 (96%) of the respondents took a biopsy before surgery. Regional lymph node scanning was routinely done by 14/23 (61%) and a systemic screening of a metastatic disease by 13/23 (57%). 6/22 (27%) never took conjunctival mapping biopsies and 12/23 (52%) never screened for Muir-Torre. Respondents used Mohs surgery, frozen section or multi-stage excision with delayed closure, and 5-6 mm was the mostly preferred margin. Sentinel lymph node biopsy was a possible option for 9/22 (41%) and cryotherapy and Mitomycin C for 6/22 (27%) respondents. 50% of respondents considered radiation as a treatment option. 15/16 (94%) respondents always followed-up their patients, most for 5 years. Two thirds scanned regional lymph nodes during the follow-up. Consensus was reached for 18 statements representing three domains: preoperative work-up, treatment and follow-up. Conclusion: Treatment practices differ in between the five Nordic countries which have similar public health care systems. In the article the authors present a Nordic consensus for the treatment of eyelid sebaceous carcinoma.

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Section: Preoperative Work-upcontrasting

confidence: 60%

“…Consider, if there is suspected conjunctival involvement. [1,13,[19][20][21] Regional lymph node scanning…”

Section: Follow-upmentioning

confidence: 99%

Nordic treatment practices survey and consensus for treatment of eyelid sebaceous carcinoma

et al. 2020

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“…Of these 28 cases, the superior tarsal and forniceal conjunctivae were involved in all cases, even when the presumed origin was the lower lid. In another series of 45 ocular sebaceous carcinoma which underwent map biopsies, in cases of upper lid disease, the superior and inferior conjunctivae were similarly likely to have positive map biopsy (31–36%) . However, this study was retrospective and map biopsies may have been targeted to clinically suspicious areas which would produce a higher positive rate than if all cases underwent routine lower lid map biopsies.…”

Section: Investigationsmentioning

confidence: 82%

Cutaneous sebaceous carcinoma

Rajak

Huilgol

et al. 2020

Aust J Dermatology

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Cutaneous sebaceous carcinoma occurs almost exclusively on the head and neck and has a significant propensity for recurrence and metastasis. It is easily mistaken for benign conditions, resulting in inappropriate management. Thus, it is important to maintain a high index of suspicion. Despite previous reports, sebaceous carcinoma may occur with similar frequency in Asians and whites. Recent genetic data suggest there are multiple mutational groups of sebaceous carcinoma, paving the way for targeted treatment. After a diagnosis, investigations for staging and for Muir-Torre syndrome should be considered. The available evidence on the treatment options for sebaceous carcinoma is discussed, and specific recommendations for management are made.

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“…More respondents chose CT orbit over MRI orbit, perhaps due to the availability and affordability of CT over MRI. Some series suggest map biopsies for all cases because even in solitary nodular SC with no conjunctival involvement clinically, half had biopsy-proven conjunctival involvement [19]. Others perform map biopsy only if there is clinical suspicion of diffuse palpebral and bulbar conjunctival involvement [20].…”

Section: Discussionmentioning

confidence: 99%

The practice patterns in the management of sebaceous carcinoma of the eyelid in the Asia Pacific region

Cheung

Esmaeli

Lam

et al. 2019

Eye

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Purpose To determine the practice patterns of ophthalmic plastic surgeons regarding the management of eyelid sebaceous carcinoma (SC). Methods An electronic survey was distributed to oculoplastic surgical colleagues in the Asia Pacific region requesting clinical information and treatment approaches to SC. Results The responses from 192 respondents from the Asia Pacific region was included and analyzed in this study. For initial diagnosis, most surgeons selected incisional biopsy (55%), followed by complete excision (35%). Initial workup was mainly by palpation of lymph nodes, chest X-ray, and computerized tomography scan (CT-scan) of the orbit. Conjunctival map biopsy was done in selected cases. Sentinel lymph node biopsy (SLNB) was done mainly for tumors larger than 10 mm. Management was mainly by surgical excision (5 mm margin) combined with adjuvant therapy in some cases, with radiotherapy being the most common. Margin status was determined most frequently by frozen section as evaluated by the pathologist (57%) followed by Mohs micrographic surgery (18%). Surveillance was based mainly on physical examination alone. Conclusion The Asia Pacific oculoplastic surgeons prefer incisional biopsy for lesions suspicious of SC prior to definitive surgery. This is in contrast to survey results previously reported in other populations. Frozen section control (done by an oculoplastic surgeon with pathology support) is most commonly used for margin control and conjunctival map biopsies are done only in selected cases. Despite the potential benefits of SLNB, access and expertise in this area is currently lacking in the Asia Pacific region.

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An Analysis of Conjunctival Map Biopsies in Sebaceous Carcinoma

Cited by 23 publications

References 11 publications

Nordic treatment practices survey and consensus for treatment of eyelid sebaceous carcinoma

Nordic treatment practices survey and consensus for treatment of eyelid sebaceous carcinoma

Cutaneous sebaceous carcinoma

The practice patterns in the management of sebaceous carcinoma of the eyelid in the Asia Pacific region

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