| Purpose: To review the clinical features, histopathological features, management and outcomes in 70 patients with sebaceous carcinoma of the eyelid and adjacent structures.
Methods: Single-center retrospective interventional case series. Seventy cases of the sebaceous gland carcinoma were retrieved from the ophthalmology archives at Tongren Hospital between 1997 and 2005. All patients were followed-up. Clinical data of all patients were reviewed from the charts; Pathology specimens were reviewed in all cases.
Results: A total of 37 female and 33 male patients were identified, The median age at diagnosis was 62 years (range, 16-84). Initial clinical diagnoses elsewhere were sebaceous carcinoma(41.4%), chalazion(32.9%), basal cell carcinoma(7.1%), squamous cell carcinoma(2.9), and other or not available(15.7%). Initial histopathologic diagnoses were sebaceous carcinoma(78.6%), basal cell carcinoma(5.7%), squamous cell carcinoma(2.9%) and other or not available(12.8%). Initial anatomic sites were upper eyelid(60%), lower eyelid (27.1%), orbit（7.1%）and caruncle(2.9%), and bulbar conjunctiva(1.4%[1 case]). The treatment involved excisional techniques with reconstruction in 57 cases, orbital exenteration in 6 cases, local excision and radiotherapy in 1 case, cryotherapy in 1 case. 5 cases were performed regional lymph node excision because of local metastases. Follow-up ranged from 12 months to 115 months, median of 52.7 months. Local recurrence developed in 57.1% and no one died form metastatic sebaceous carcinoma.
Conclusion: There was no significant female distinction in this study, which is not coincidence with most other reports. Clinical misdiagnosis rate is lower than western countries, but local recurrence was much higher. The high recurrence was correlated with inadequate excision and intraepithelial involvement growth pattern. From this study, patients in China have a better prognosis than is indicated in the literature. Early diagnosis and radical surgical approaches leads to a better outcome and higher survival rates.
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