Sebaceous carcinoma of the eyelid: a clinicopathological study

Zürcher, M.; Hintschich, C.; Garner, A; Bunce, Catey; Collin, J. R. O.

doi:10.1136/bjo.82.9.1049

Cited by 160 publications

(159 citation statements)

References 32 publications

Supporting

Mentioning

135

Contrasting

Unclassified

Order By: Relevance

“…Studies have been performed to investigate such markers in tumors with sebaceous differentiation. 11,14,15,17 In our study, we examine a series of tumors that can enter the differential diagnosis with sebaceous neoplasia for expression of adipophilin. We show vesicular staining for adipophilin in the sebocytes of normal sebaceous glands, in 16 of 16 (100%) sebaceous adenomas and 23 of 25 (92%) sebaceous Table 3 Eyelid lesions: grading of adipophilin staining results carcinomas, including 9 of 11 (82%) cases of poorly differentiated sebaceous cell carcinomas.…”

Section: Discussionmentioning

confidence: 99%

“…It is particularly important to differentiate these entities because their behavior is generally less aggressive than sebaceous carcinoma. 5,11 Other lesions with clear cell histology, such as xanthomatous lesions, tumors originating in the outer root sheath cells of hair follicle, balloon cell nevi, and, sometimes, metastatic renal cell carcinoma can be difficult to distinguish in small biopsy specimens.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Adipophilin expression in sebaceous tumors and other cutaneous lesions with clear cell histology: an immunohistochemical study of 117 cases

et al. 2010

View full text Add to dashboard Cite

Adipophilin is a monoclonal antibody against a protein on the surface of intracellular lipid droplets, and it was recently shown to be expressed in sebocytes and sebaceous lesions. This study examines adipophilin expression in various sebaceous lesions and other cutaneous tumors with a clear cell histology that may mimic sebaceous differentiation. A total of 117 cutaneous clear cell lesions including 16 sebaceous adenomas, 25 sebaceous carcinomas, 8 basal cell carcinomas, 12 squamous cell carcinomas, 6 xanthomas, 10 xanthelasmas, 10 xanthogranulomas, 4 balloon cell nevi, 5 trichilemmomas, 8 clear cell hidradenomas, and 13 metastatic renal cell carcinomas were examined using immunohistochemistry for the expression of adipophilin. Of these 117 lesions, 42 (36%) were from the periocular region. Adipophilin was expressed in 16 of 16 (100%) sebaceous adenomas, 23 of 25 (92%) sebaceous carcinomas, 10 of 10 (100%) xanthelasmas, 9 of 10 (90%) xanthogranulomas, 6 of 6 (100%) xanthomas, and 9 of 13 (62.5%) metastatic renal cell carcinomas. The characteristic staining pattern differed between sebaceous and non-sebaceous tumors with the former showing a membranous vesicular pattern and the latter being more granular. Adipophilin expression was not seen in any of the other lesions with clear cell histology, basal cell carcinomas, or squamous cell carcinomas, including cases that had focal clear cell differentiation. Adipophilin can be valuable in an immunohistochemical panel when evaluating cutaneous lesions with clear cell histology as it identifies intracytoplasmic lipid vesicles in sebaceous and xanthomatous lesions. In periocular lesions, it is effective in helping to exclude basal cell carcinoma and squamous cell carcinoma when sebaceous carcinoma is under consideration. Adipophilin expression is not as useful for the differential diagnosis that includes metastatic renal cell carcinoma, a rare but important, diagnostic differential. The pattern of adipophilin reactivity is important to observe as membranous vesicular staining is suggestive of intracellular lipids whereas granular cytoplasmic reactivity is not. Modern Pathology (2010) 23, 567-573; doi:10.1038/modpathol.2010.1; published online 29 January 2010Keywords: adipophilin; sebaceous tumors; differential diagnosis Sebaceous carcinoma is a relatively uncommon tumor comprising 0.05% of all cutaneous malignancies, but is the second or third most common malignant eyelid tumor in most series accounting for 2-4% of periocular tumors. 1 Local recurrence complicates 6-29% of periocular sebaceous cell carcinomas. [2][3][4][5] Regional or distal metastases affect 14-25% of patients with an associated 5-year mortality ranging from 30 to 67% according to different reports. 2,4 Owing to its variable clinical appearance, sebaceous carcinoma mimics both benign processes, such as chalazions and blepharitis, and other malignant

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Adipophilin expression in sebaceous tumors and other cutaneous lesions with clear cell histology: an immunohistochemical study of 117 cases

et al. 2010

View full text Add to dashboard Cite

show abstract

“…The majority of all recurrences appear within the first 4 years after treatment. 18 The rate of metastasis at 5 years was 16.1%. Four of our patients with SGC developed regional lymph node metastasis and received parotidectomy, radical neck dissection, and chemotherapy or radiotherapy.…”

Section: Sgcmentioning

confidence: 93%

“…According to the literature, distant metastasis affects 14-25% of the cases and involves lymph node or hematogenous spread into liver, lungs, brain, and bones. 18 SGC is traditionally considered among the most lethal of all tumours of the ocular adnexa. Mortality from SGC has been estimated to be from 6 to 30% in a previous study.…”

Section: Sgcmentioning

confidence: 99%

Malignant eyelid tumours in Taiwan

Wang

Liao

Jou

et al. 2003

Eye

View full text Add to dashboard Cite

Aims To describe the clinical characteristics of patients with eyelid cancers in Taiwan. Methods Between 1980 and 2000, 127 (58 males and 69 females) patients (mean age 62.6; range 10-91 years) with histologically confirmed eyelid cancers were retrospectively evaluated at the National Taiwan University Hospital and Far Eastern Memorial Hospital in Taiwan. Clinical data of all patients were reviewed from medical records. The mean follow-up period was 62.4 months (range 3-240) for 113 patients. Results The 127 eyelid cancers included 79 basal cell carcinomas (62.2%), 30 sebaceous gland carcinomas (23.6%), 11 squamous cell carcinomas (8.7%), five malignant melanomas (3.9%), one Kaposi's sarcoma (0.8%), and one metastatic cancer (0.8%). Tumours developed more commonly in the lower (37.0%) than the upper eyelid (33.9%). The clinical accuracy in predicting eyelid malignancy was 90.5%. Primary treatment modality was mainly surgical excision. The recurrence, metastasis, and mortality rates at 5 years were 15.2, 11.7, and 7.3%, respectively, for all eyelid malignancies. Rates of sebaceous gland carcinoma recurrence, metastasis, and mortality were significantly higher (Po0.05) than those of basal cell carcinoma. The mean interval of recurrence or metastasis after primary treatment was 26.3 months (range 4-112) for all eyelid cancers. Conclusions Although basal cell carcinoma is the most common eyelid cancer in Taiwan, sebaceous gland carcinoma is also common. Of the two, basal cell carcinoma has a better prognosis and sebaceous gland carcinoma has a higher mortality and therefore should be treated much more aggressively. Long-term follow-up is needed after treatment of malignant eyelid tumours.

show abstract

“…[5][6][7] Pagetoid invasion of the conjunctiva can be detected by conjunctival map biopsies, 8 and may be an indication for exenteration, although a recent paper has reported the effective use of topical Mitomycin-C in such patients. 9 This patient had a very small tumour, but pagetoid spread meant that 75% of her upper eyelid was excised to clear this.…”

Section: Commentmentioning

confidence: 99%