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Four-Eyelid Sebaceous Cell Carcinoma Following Irradiation
Arch Ophthalmol. 1998;116:1670-1672.
Background Sebaceous cell carcinoma is a distinctive tumor of the eyelid associated with a high rate of metastasis and mortality. Involvement of both upper and lower lids has been described; however, involvement of all 4 eyelids is extremely rare.
Objective To describe the evaluation and diagnosis of the clinicopathologic features in a 74-year-old patient with 4-eyelid sebaceous carcinoma and a history of whole face irradiation for eczema.
Methods Bilateral eyelid, conjunctiva, map, and fine needle biopsy of enlarged, submandibular lymph node specimens were stained with hematoxylin-eosin and oil-red-O for light microscopy and fresh-frozen sections were evaluated by electron microscopy.
Results The biopsy specimens from the eyelids and conjunctiva showed sebaceous carcinoma cells in the meibomian glands and scattered within the conjunctival epithelium. The cells were moderately well differentiated. Similar cells stained with oil-red-O were found in the submandibular lymph nodes.
Conclusions The appearance of bilateral sebaceous carcinoma supports the concept of simultaneous occurrence of multiple primaries in specific patients, especially after radiation therapy. Patients with a history of facial irradiation and atypical eyelid lesions should be evaluated for malignant tumors such as sebaceous carcinoma.
Shimon Rumelt, MD;
Nick R. Hogan, MD;
Peter A. D. Rubin, MD;
Frederick A. Jakobiec, MD
From the Eye Plastics Service and Orbit Center (Drs Rumelt and Rubin), and Ophthalmic Pathology and Oncology Unit (Drs Hogan and Jakobiec), Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston.
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