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眼部皮脂腺癌的临床诊断与治疗进展:文献综述

Updates on the clinical diagnosis and management of ocular sebaceous carcinoma: a brief review of the literature.

作者信息

Xu Yangfan, Li Fang, Jia Renbing, Fan Xianqun

机构信息

Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China,

Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, People's Republic of China,

出版信息

Onco Targets Ther. 2018 Jun 27;11:3713-3720. doi: 10.2147/OTT.S162073. eCollection 2018.

Abstract

Ocular sebaceous carcinoma (SC) is an exceedingly rare but aggressive malignancy that can impair patients' visual acuity or even cause tumor-specific mortality. This tumor usually mimics chronic benign eyelid lesions, thus leading to delayed diagnosis, thereby causing high recurrence and metastasis. Ophthalmologists should be more aware of SC in order to offer correct diagnosis and treatment at the onset of symptoms. Prompt surgical excision with frozen section margin control is the mainstay of SC management after patient evaluation and accurate biopsy. Mohs micrographic surgery has been associated with better tumor control outcomes than wide local excision. Radiation therapy should be considered as adjuvant treatment for locally advanced (stage T3a or higher) or high-risk (pagetoid spread) SC, nodal metastasis, or palliative care. Cryotherapy and topical chemotherapy are used for pagetoid spread. Targeted therapy has an emerging role in more complicated cases. For lymph node and distant metastasis, combination treatments should be provided, including lymph node and neck dissection, radiation therapy, systemic chemotherapy, and even orbital exenteration. The rarity of ocular SC precludes a comprehensive perspective on standard treatment. This paper offers a brief review of recent advances in the clinical diagnosis and management of ocular SC based on current scientific literature.

摘要

眼部皮脂腺癌(SC)是一种极为罕见但具有侵袭性的恶性肿瘤,可损害患者的视力,甚至导致肿瘤特异性死亡。这种肿瘤通常类似于慢性良性眼睑病变,从而导致诊断延迟,进而引起高复发率和转移率。眼科医生应更加了解眼部皮脂腺癌,以便在症状出现时提供正确的诊断和治疗。在对患者进行评估和准确活检后,采用术中冰冻切片控制切缘的快速手术切除是眼部皮脂腺癌治疗的主要方法。与广泛局部切除相比,莫氏显微外科手术已被证明具有更好的肿瘤控制效果。放射治疗应被视为局部晚期(T3a期或更高)或高危(派杰样扩散)眼部皮脂腺癌、淋巴结转移或姑息治疗的辅助治疗。冷冻疗法和局部化疗用于派杰样扩散。靶向治疗在更复杂的病例中发挥着越来越重要的作用。对于淋巴结和远处转移,应提供联合治疗,包括淋巴结清扫和颈部清扫、放射治疗、全身化疗,甚至眼眶内容剜除术。眼部皮脂腺癌的罕见性使得难以全面了解其标准治疗方法。本文基于当前科学文献,对眼部皮脂腺癌临床诊断和治疗的最新进展进行简要综述。

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