F-18 FDG PET Evaluation of a Rapidly Growing Extraocular Sebaceous Carcinoma

Abstract

Sebaceous carcinoma (SC) is an aggressive malignant tumor derived from the epithelium of sebaceous glands. SC mostly occurs in the skin of the ocular region. Extraocular SC most commonly involve the skin of the face, the head, and neck region and very rarely the upper arm (3.9% of all SCs).A case of rapidly growing extraocular SC of the upper arm was staged with FDG PET. The FDG-PET findings of FDG uptake in the primary lesion and metastases were consistent with autopsy analyses.

Management Considerations in Extraocular Sebaceous Carcinoma

“…However, there are isolated reports of using imaging to stage extraocular SC with magnetic resonance imaging (MRI) 36,37 and positron emission tomography scan (PET). 38 Some have recommended the use of CT scan 6 PET as an imaging modality for patients with palpable regional lymphadenopathy, nodal metastasis on SLNB, or primary lesions, demonstrating aggressive features clinically or histologically. 32 For ocular SCs, expert's opinion advocates for imaging at staging and serial evaluation.…”

Impact of surgery and adjuvant treatment on the outcome of extraocular sebaceous carcinoma: a systematic review and individual patient's data analysis of 206 cases

“…Although PET scan has not been evaluated for these diseases, a PET CT may be beneficial for diagnosing distant metastasis for patients with extensive locoregional disease. 13 In the present analysis, surgery was performed for 93.5% of patients, which clearly indicates surgery to be the cornerstone of therapy. Interestingly, only 11 patients had a Mohs micrographic surgery pointing toward the aggressiveness of EOSC, not amenable to such a conservative approach.…”

“…In addition, the analysis also found better OS and PFS for patients with a localized disease compared to those with metastatic disease. Although PET scan has not been evaluated for these diseases, a PET CT may be beneficial for diagnosing distant metastasis for patients with extensive locoregional disease …”