Demirci Hakan, Nelson Christine C, Shields Carol L, Eagle Ralph C, Shields Jerry A
Eye Plastic, Orbital, and Facial Cosmetic Surgery, Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan 48105, USA.
Ophthalmic Plast Reconstr Surg. 2007 Jan-Feb;23(1):77-9. doi: 10.1097/IOP.0b013e31802c7e45.
We report the rare but serious association between sebaceous carcinoma of eyelid and Muir-Torre syndrome in two cases, a 79-year-old woman and 54-year-old man. The presenting sign was a yellow-pink nodule with telangiectatic vessels on the left lower eyelid in one patient and a yellowish-red, pedunculated lesion with intrinsic vascularization on the right superior tarsal conjunctiva in the other. A history of multiple primary colon cancers was present in both patients, associated transitional cell carcinoma of bladder and renal cancer in one patient and prostate cancer in the other. Both patients underwent excisional biopsy and cryotherapy of the eyelid tumors. Histopathology revealed sebaceous carcinoma of eyelid and conjunctiva. Immunohistochemical staining for MSH2 DNA mismatch repair gene performed in one patient showed lack of expression. Muir-Torre syndrome was diagnosed on the basis of sebaceous carcinoma, associated with multiple visceral malignancies in both patients. We conclude that patients with sebaceous carcinoma should have evaluation for visceral malignancies, mainly colon cancer.
我们报告了两例眼睑皮脂腺癌与穆尔-托雷综合征之间罕见但严重的关联,一例为79岁女性,另一例为54岁男性。其中一名患者的表现体征是左下眼睑有一个带有毛细血管扩张血管的黄粉色结节,另一名患者的表现体征是右上睑结膜有一个带蒂的黄红色病变,伴有内在血管形成。两名患者均有多发原发性结肠癌病史,其中一名患者还伴有膀胱移行细胞癌和肾癌,另一名患者伴有前列腺癌。两名患者均接受了眼睑肿瘤的切除活检和冷冻治疗。组织病理学显示为眼睑和结膜皮脂腺癌。对其中一名患者进行的MSH2 DNA错配修复基因免疫组化染色显示无表达。根据皮脂腺癌以及两名患者均伴有多种内脏恶性肿瘤,诊断为穆尔-托雷综合征。我们得出结论,皮脂腺癌患者应评估是否存在内脏恶性肿瘤,主要是结肠癌。