Excision and Delayed Reconstruction With Paraffin Section Histopathological Analysis for Periocular Sebaceous Carcinoma

Abstract

Excision and delayed reconstruction using paraffin section histopathological analysis are in widespread use for the management of basal cell carcinomas in the periocular region. While some authors advocate the use of Mohs' micrographic surgery in patients with SC, this technique has been questioned due to the possible misinterpretation of subtle intraepithelial pagetoid spread with frozen section analysis. To preserve the function of the eyelid and ease of reconstruction, it is important to try and preserve as much healthy tissue as possible while effecting a successful excision. Excision and delayed reconstruction offer an excellent option for the management of this rare and highly malignant tumor.

Management of recurrent sebaceous gland carcinoma

“…It is estimated that 41–80% of SGC have associated pagetoid spread [ 14 ]. Contemporary studies report local tumour recurrence in 12–25% of patients [ 1 , 5 , 10 , 12 , 15 ].…”

“…Local anaesthesia was obtained with a subcutaneous injection of 0.5% bupivacaine with adrenaline 1 in 200000. Our technique of full thickness excision with delayed reconstruction has been previously described [ 12 ]. As well as primary lesions, 8–10 conjunctival mapping biopsies were also taken from all quadrants of bulbar and tarsal conjunctiva and sent separately on microsponge pieces, in formalin with a diagram (see Fig.…”

Programmed death receptor Ligand 1 expression in eyelid sebaceous carcinoma: a consecutive case series of 41 patients

“…Although SC clinical features have been reported and various treatment modalities have been performed, delayed diagnosis with metastasis to regional lymph nodes and distant organs often occurs in 3–41% of all patients with eyelid SCs (While et al. ). Consistent with previous reports, our consecutive study showed that 21.9% (9/41) of the patients experienced nodular metastasis and 2.4% (1/41) showed metastasis to distant organs, involving five patients who twice experienced recurrence, followed by frozen section procedures before metastasis, and one patient who died of lung metastasis 12 months after a frozen section + unilateral neck dissection + unilateral radical parotidectomy.…”

Updates on the clinical diagnosis and management of ocular sebaceous carcinoma: a brief review of the literature

“…Radiotherapy, cryotherapy, topical chemotherapy, amniotic membrane grafting, flap reconstruction, and other techniques are followed by surgical excision to achieve the best treatment effect. 5 , 13 , 16 , 37 , 38 …”