Khan J A, Doane J F, Grove A S
Department of Ophthalmology, Kansas University Medical Center, Kansas City 66103.
Ophthalmic Plast Reconstr Surg. 1991;7(1):61-6. doi: 10.1097/00002341-199103000-00008.
Sebaceous carcinoma of the eyelid is frequently misdiagnosed clinically and histopathologically. The tumor may present as a lid mass, recurrent chalazion, or diffuse unilateral blepharoconjunctivitis. Fifty percent of cases are misdiagnosed, often by an inexperienced general pathologist interpreting the initial biopsy. Frozen-section monitoring of surgical margins has been reported unreliable in 25% of cases. Mohs surgery is also unreliable in cases where there is pagetoid intraepithelial spread or skip lesions. This tumor may spread regionally into the lacrimal secretory and excretory systems, to regional lymph nodes, and rarely disseminate hematogenously. Guidelines for management are discussed.
眼睑皮脂腺癌在临床和组织病理学上常被误诊。该肿瘤可能表现为眼睑肿物、复发性睑板腺囊肿或弥漫性单侧睑结膜炎。50%的病例被误诊，通常是由经验不足的普通病理学家解读最初的活检结果。据报道，25%的病例中手术切缘的冰冻切片监测不可靠。在存在派杰样上皮内扩散或跳跃性病变的情况下，莫氏手术也不可靠。这种肿瘤可能局部扩散至泪液分泌和排泄系统、局部淋巴结，很少经血行播散。文中讨论了治疗指南。
