Currie Gabriel P, Plaza Jose A, Harris Gerald J
Departments of *Dermatology, †Pathology, and ‡Ophthalmology, Medical College of Wisconsin, Milwaukee, WI.
Am J Dermatopathol. 2014 Aug;36(8):673-6. doi: 10.1097/DAD.0000000000000045.
Sebaceous carcinoma is a malignant neoplasm that occurs most commonly in the periorbital area, usually the eyelid. Its periocular location predisposes to smaller biopsies, thus complicating diagnosis. The neoplasm tends to exhibit aggressive local behavior, metastasizing to regional lymph nodes, and distant organs. Disease limited to the epithelium is rare, with less than 10 cases reported in the literature. We present the case of a 73-year-old woman who presented with left upper eyelid entropion and conjunctival erythema. Multiple punch biopsies showed an intraepithelial proliferation of atypical basaloid cells with enlarged and hyperchromatic nuclei intermingled with vacuolated cells containing bubbly cytoplasms and scalloped nuclei, consistent with a diagnosis of intraepithelial sebaceous carcinoma. After subsequent orbital exenteration and histological examination, a wide intraepithelial sebaceous component was identified; however, there was no invasive growth. This case highlights the rarity and the potential diagnostic pitfalls of intraepithelial sebaceous carcinoma.
皮脂腺癌是一种恶性肿瘤，最常发生于眶周区域，通常是眼睑。其眼周部位导致活检样本较小，从而使诊断变得复杂。该肿瘤往往表现出侵袭性的局部行为，可转移至区域淋巴结和远处器官。局限于上皮的疾病很罕见，文献报道不足10例。我们报告一例73岁女性，表现为左上睑内翻和结膜红斑。多次穿刺活检显示非典型基底样细胞上皮内增生，细胞核增大、染色质增多，与含有泡沫状细胞质和扇贝状细胞核的空泡化细胞混合，符合上皮内皮脂腺癌的诊断。在随后的眼眶内容剜除术和组织学检查后，发现广泛的上皮内皮脂腺成分；然而，没有浸润性生长。该病例突出了上皮内皮脂腺癌的罕见性和潜在的诊断陷阱。
