Leibovitch Igal, Selva Dinesh, Huilgol Shyamala, Davis Garry, Dodd Thomas, James Craig L
Oculoplastic & Orbital Unit, Department of Ophthalmology and Visual Sciences, Royal Adelaide Hospital, University of Adelaide, Adelaide, South Australia, Australia.
J Cutan Pathol. 2006 Apr;33(4):303-8. doi: 10.1111/j.0303-6987.2006.00423.x.
Sebaceous carcinoma (SC) is well known for its ability to masquerade clinically and histologically as a variety of periocular conditions resulting in a delayed diagnosis. We present a series of periocular SC cases and discuss the difficulties in histopathological diagnosis when this tumor presents with a Bowenoid pattern of intraepithelial spread.
A retrospective case study of all patients with SC of the eyelid treated in our Hospital, from 1997 to 2004, was conducted.
Eight patients were identified (four females and four males). Seven cases involved the upper eyelid. Initial clinical diagnoses included blepharitis (three cases), blepharoconjunctivitis (one case), cicatrizing conjunctivitis (one case), and lid lesions (two cases). Histopathologically, 87.5% of cases were misdiagnosed as Bowen's disease (BD) on the initial biopsy. Six of these cases showed no invasive disease on the initial biopsy and were eventually found to be invasive SC on subsequent excisions. In one case, the tumor was wholly in situ. Delay in diagnosis ranged from 0 to 56 months.
SC should always be considered in the histological differential diagnosis of any eyelid lesion which resembles BD, particularly if the upper eyelid is involved or if multivacuolated cytoplasmic clear cell changes are seen.
皮脂腺癌（SC）因其在临床和组织学上可伪装成多种眼周疾病而导致诊断延迟而闻名。我们展示了一系列眼周皮脂腺癌病例，并讨论了该肿瘤呈现鲍温样上皮内扩散模式时在组织病理学诊断中遇到的困难。
对1997年至2004年在我院接受治疗的所有眼睑皮脂腺癌患者进行回顾性病例研究。
共确定8例患者（4例女性，4例男性）。7例累及上睑。初始临床诊断包括睑缘炎（3例）、睑结膜炎（1例）、瘢痕性结膜炎（1例）和眼睑病变（2例）。组织病理学上，87.5%的病例在初次活检时被误诊为鲍温病（BD）。其中6例在初次活检时未发现浸润性疾病，最终在后续切除时发现为浸润性皮脂腺癌。1例肿瘤完全处于原位。诊断延迟时间为0至56个月。
在对任何类似鲍温病的眼睑病变进行组织学鉴别诊断时，尤其是累及上睑或见到多空泡细胞质透明细胞改变时，应始终考虑皮脂腺癌。
