Sebaceous carcinoma

Abstract

Ocular sebaceous carcinoma (SC) is an uncommon adnexal tumor that typically occurs on the upper eyelids, in white women at an average age of 72. The best outcome is achieved when the tumor status is primary, present on the central lid, less than 6 months duration, less than 6 mm in size, and devoid of pagetoid conjunctival spread. Pagetoid spread is present in about 50-80% of primary tumors. Classic Mohs surgery uses frozen sections to recognize pagetoid cells. These can be supplemented with paraffin sections especially for assessment of epithelial margins. The Mohs surgery local success rate for primary and recurrent SC is 88% and 70%, respectively. Our updated review accumulated 57 patients; the overall local recurrence rate following Mohs surgery was 12.3% (7 of 57), regional metastasis 8.8% (5 of 57), and no deaths. These results compare favorably to standard wide excision with local recurrence of 18%, regional metastasis of 8%, and 6% deaths.