[Sebaceous carcinoma of the eyelids--case reports and review of the literature].

BACKGROUND

Sebaceous carcinomas are among the most rarely found skin tumours (0.2 - 4.6 %). As with most skin tumours the predominant region of occurrence is the head and neck, in particular the eyelids. The cytological origins are foremost the Meibomian and the glands of Zeis.

CASE REPORTS

We report on two female patients suffering from sebaceous carcinoma of the upper and lower lid. The time span from initial treatment up to definite diagnosis and treatment was one year. In both cases the tumour was radically removed surgically and the eyelid reconstructed. In the first case there was no tumour recurrence within six years after surgery. In the second case a lymph node metastasis of the parotid gland was found seven years after initial therapy and surgically removed followed by a complete parotidectomy and neck dissection.

DISCUSSION

As the sebaceous carcinomas are difficult to differentiate from other kinds of benign and malignant eyelid diseases, a considerable delay between the initial examination and final diagnosis is not uncommon. This type of tumour is characterised by a high degree of biological aggression concerning local recurrence and lymphogenous and hematogenic tumour spread. The mortality rate is reported to be between 9 and 40 %. Therapy of choice is the radical surgical removal of the tumour. Depending on preoperative findings, neck dissection may be indicated. The biological behaviour of this kind of tumour requires long-term oncological aftercare.