Ocular sebaceous gland carcinoma in Northern India: Clinico-pathological features and treatment outcome

Rajendra Maurya, Virendra Singh, Mahendra Singh, Tanmay Srivastava, Manisha Diwedi, Resident
International Journal of Ocular Oncology and Oculoplasty   unpublished
Purpose: The objective of this study was to analyze clinical presentation, histopathological spectrum and outcome of ocular sebaceous gland carcinoma in a teaching hospital. patients with suspected sebaceous gland carcinoma were enrolled from outpatient department. All patients were admitted to ward and underwent detailed history, clinical, radiological evaluation and necessary laboratory investigations. In each case incisional/ excisional biopsy were taken to study the histopathological
more » ... eristics. All patients were treated either surgically or non-surgically by single ocular oncologist. Pre and post treatment clinical photographs were taken to compare structural outcome and for purpose of documentation. Data were recorded in predesigned proforma and analyzed for demographic profile, clinico-pathological characteristics and outcomes by using SPSS 16 program. Results: Out of total 34 patients of SGC, 73.53% were females. The age range of patients was 46-82 years. The mean age of presentation was 55 years. Most frequent site of origin was the eyelid (94.12%) followed by cruncle (5.88%). Upper eyelid was the most frequently affected site (41.18%) followed by lower lid (29.41%). The medial canthus and lateral canthus were the least involved (11.76% each). Maximum duration of lesion was more than three years. The most common clinical presentation was painless mass, nodular type (82.35%) and ulcero-nodular type (17.65 %). Severe degree of mechanical ptosis was observed in 29.41% cases. Regional lymph node were involved in 20.59% patients. In 8.82% cases preauricular lymph nodes were involved in the post-excisional period. The distant metastasis was observed in three cases. 23.53% patients had tumor diameter <10 mm, 47.06% had 10 to 20 mm while in 29.41% cases tumor diameter exceeded 20mm. Histopathologically majority were well differentiated type (44.12%) however 29.41% were poorly/ undifferentiated type. 35.29% patients underwent primary surgical excision with plastic reconstruction and 23.53% received neoadjuvant systemic chemotherapy followed by surgical excision while three patients of advanced stage refused surgery and were treated by palliative chemotherapy/ radiotherapy. There was recurrence in 23.53% cases. Three patients died due to distant metastasis. Conclusion: Sebaceous gland carcinoma is slow growing malignancy, commonly occurring in upper eyelid. Nodular type is the most common presentation and well sebaceous differentiation was the commonest histopathological pattern. Its treatment is essentially surgical. Duration of lesion, tumor diameter and histological differentiation are important prognostic factors.