Chao A N, Shields C L, Krema H, Shields J A
Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
Ophthalmology. 2001 Oct;108(10):1877-83. doi: 10.1016/s0161-6420(01)00719-9.
To evaluate the clinical findings, histopathologic features, methods of management, and outcomes in 25 patients with eyelid sebaceous gland carcinoma with and without conjunctival intraepithelial (pagetoid) invasion.
Twenty-five patients with sebaceous gland carcinoma of the periocular region.
Retrospective, observational case series.
The patients were divided into two groups: group A included those with sebaceous gland carcinoma with conjunctival intraepithelial (pagetoid) invasion, and group B included those with sebaceous gland carcinoma without conjunctival intraepithelial invasion. The demographic, clinical, and histopathologic features of sebaceous gland carcinoma were reviewed separately for each group. Ocular management results and systemic prognosis were reviewed.
Of the 25 patients, 18 (72%) were females and 7 (28%) were males. The mean age at diagnosis was 65 years (range, 17-90 years). There were 11 patients (44%) in group A, and 14 (56%) in group B. The most common symptom in group A was ocular irritation (45%), and in group B the most common symptom was eyelid lump (86%). The most common sign in group A was diffuse eyelid thickening (72%), and in group B the most common sign was a distinct eyelid mass (43%). Six patients (55%) in group A, compared with one patient (7%) in group B, had both upper and lower eyelid involvement. The most frequent location of tumor epicenter was the outer third of the eyelid in both groups: 37% in group A and 57% in group B. Histopathologic origin of tumor was multicentric in four patients (36%) of group A and six patients (50%) of group B. Before referral, local recurrence had been found in 4 of 12 patients (33%) who underwent surgical treatment elsewhere. After referral, local recurrence was detected in 1 patient (9%) in group A and in 2 patients (14%) in group B. Orbital exenteration was necessary in 4 patients (36%) in group A and in one patient (7%) in group B. Tumor-related metastases occurred in two patients (18%) in group A and in two patients (14%) in group B.
Sebaceous gland carcinoma with conjunctival intraepithelial (pagetoid) invasion has different clinical features compared with that without pagetoid invasion. Conjunctival intraepithelial (pagetoid) invasion carries a higher risk for orbital exenteration, but the risk of tumor-related metastases is similar in both groups.
评估25例伴有或不伴有结膜上皮内（派杰样）浸润的眼睑皮脂腺癌患者的临床症状、组织病理学特征、治疗方法及预后。
25例眼周皮脂腺癌患者。
回顾性观察病例系列。
患者分为两组：A组为伴有结膜上皮内（派杰样）浸润的皮脂腺癌患者，B组为不伴有结膜上皮内浸润的皮脂腺癌患者。分别对两组皮脂腺癌的人口统计学、临床及组织病理学特征进行回顾。对眼部治疗结果及全身预后进行回顾。
25例患者中，18例（72%）为女性，7例（28%）为男性。诊断时的平均年龄为65岁（范围17 - 90岁）。A组有11例患者（44%），B组有14例患者（56%）。A组最常见的症状是眼部刺激感（45%），B组最常见的症状是眼睑肿物（86%）。A组最常见的体征是眼睑弥漫性增厚（72%），B组最常见的体征是明显的眼睑肿物（43%）。A组6例患者（55%）上下眼睑均受累，而B组仅1例患者（7%）上下眼睑均受累。两组肿瘤中心最常见的位置均为眼睑外1/3：A组为37%，B组为57%。A组4例患者（36%）和B组6例患者（50%）的肿瘤组织病理学起源为多中心性。在转诊前，12例在其他地方接受手术治疗的患者中有4例（33%）出现局部复发。转诊后，A组1例患者（9%）和B组2例患者（14%）出现局部复发。A组4例患者（36%）和B组1例患者（7%）需要进行眼眶内容剜除术。A组2例患者（18%）和B组2例患者（14%）出现与肿瘤相关的转移。
伴有结膜上皮内（派杰样）浸润的皮脂腺癌与不伴有派杰样浸润的皮脂腺癌具有不同的临床特征。结膜上皮内（派杰样）浸润导致眼眶内容剜除术的风险更高，但两组与肿瘤相关的转移风险相似。
