Deo S V S, Shukla Nootan Kumar, Singh Mandeep, Jha Deepak, Khanna Paras, Kallianpur Ashwin
Department of Surgical Oncology, Dr BR Ambedkar Institute Rotary cancer Hospital, All India Institute of Medical Sciences, Delhi, India.
Orbit. 2012 Jun;31(3):150-4. doi: 10.3109/01676830.2011.648799.
Sebaceous carcinoma (SbCC) is a rare malignancy that often mimics benign conditions. Lymphatic involvement, large T3 tumors herald a dismal survival for patients. We present our series of 13 cases of locally advanced SbCC of the eyelid treated at a surgical oncology unit and describe the clinical profile, patterns of nodal spread and recurrence pattern in this subset of SbCC.
A retrospective analysis of case records was carried out for patients presenting with orbital tumors between January 1997 and April 2010 in the department of Surgical Oncology, AIIMS, New Delhi, India. All patients underwent orbital exenteration and superficial parotidectomy with neck dissection was added to patients with clinically significant lymphadenopathy. All patients who underwent OE after 2002 were advised radiotherapy as adjuvant therapy. The end point was development of recurrence or end of two year follow up period which ever occurred earlier.
Thirteen patients underwent orbital exenteration. Eleven patients had clinically palpable lymphadenopathy. Ten patients (76.9%) had pathologically confirmed metastatic nodes. Parotid lymph node involvement was present in all patients (100%); two of these ten patients also had level II b cervical lymph node involvement. Recurrence was observed in seven patients (53.8%). All recurrences were loco-regional only and no systemic metastases was seen. There were only two recurrences in the group that received PORT.
Eyelid SbCC is a loco-regionally aggressive malignancy and adequate disease control can be achieved with combined modality approach of radical surgery followed by post operative radiotherapy.
皮脂腺癌（SbCC）是一种罕见的恶性肿瘤，常表现为良性病变。出现淋巴受累、大的T3肿瘤提示患者预后不佳。我们报告了在一个外科肿瘤治疗单元接受治疗的13例局部晚期眼睑SbCC病例系列，并描述了该亚型SbCC的临床特征、淋巴结转移模式和复发模式。
对1997年1月至2010年4月在印度新德里全印医学科学研究所外科肿瘤学系就诊的眼眶肿瘤患者的病例记录进行回顾性分析。所有患者均接受了眼眶内容剜除术，对于有临床意义的淋巴结肿大患者，加行了腮腺浅叶切除术及颈部淋巴结清扫术。2002年后接受眼眶内容剜除术的所有患者均接受了放疗作为辅助治疗。终点指标为复发的发生或两年随访期结束，以较早发生者为准。
13例患者接受了眼眶内容剜除术。11例患者有临床可触及的淋巴结肿大。10例患者（76.9%）经病理证实有转移性淋巴结。所有患者（100%）均有腮腺淋巴结受累；这10例患者中有2例同时有Ⅱb级颈淋巴结受累。7例患者（53.8%）出现复发。所有复发均仅为局部区域性，未观察到远处转移。接受术后放疗的患者组中仅2例复发。
眼睑SbCC是一种局部区域性侵袭性恶性肿瘤，采用根治性手术联合术后放疗的综合治疗方法可实现对疾病的充分控制。
