Ul Kadir Syeed Mehbub, Rani Mitra Mukti, Rashid Riffat, Nuruddin Murtuza, Hassan Khan Md Kamrul, Haider Golam, Nessa Mst Sayedatun
Training and Academic, Sheikh Fazilatunnesa Mujib Eye Hospital and Training Institute, Gopalgonj, Bangladesh.
Department of Ophthalmology, Dhaka Medical College Hospital, Dhaka, Bangladesh.
J Skin Cancer. 2022 Feb 18;2022:4075668. doi: 10.1155/2022/4075668. eCollection 2022.
Eyelid tumours are common in our ophthalmic practice. Malignancy cases account only for one-fourth of all eyelid tumours. The most aggressive eyelid malignancy is sebaceous gland carcinoma, but its occurrences are rare in western countries. We found sebaceous gland carcinoma is as common as basal cell carcinoma in our clinical practices. Hence, it is essential to build awareness about the more aggressive eyelid malignancies to reduce morbidity and mortality.
To assess the relative frequency of eyelid malignancies in the Bangladesh population, state their clinical features and outcome of management strategies and build awareness about the more aggressive eyelid malignancies to reduce morbidity and mortality.
This was a retrospective case series study of 332 patients in Bangladesh. This study analyzed all the recorded data of the histologically proven primary eyelid malignancies and followed them up for at least six months from 2014 to 2019 (6 years). All patients were managed by surgical excision with tumor-free margins verified on histopathology, either the frozen section or excision biopsy with 2-3 mm microscopic view of normal tissue followed by eyelid reconstruction. Computer-based statistical software SPSS was used for the analysis, and an appropriate test of significance (chi-square) was used for the statistical analysis.
Sebaceous gland carcinoma (SGC) was the highest in occurrence, at 42%, followed by 38% basal cell carcinoma (BCC), 18% squamous cell carcinoma (SqCC), and 02% malignant melanoma (MM). The mean age at presentation of SGC, BCC, SqCC, and MM were 57.41 years, 62.56 years, 64.73 years, and 59.28 years, respectively. Female (59%) was slightly more preponderance over the male (41%) for SGC than other malignancies. Pigmentation was associated with malignant melanoma (100%) and BCC (81%). Statistically, a significant difference was found between eyelid malignancies, including location, size, pigmentation, recurrence, and invasiveness. The recurrence rate was low lower in the patients who underwent frozen section biopsy (3%) for margin clearance than those who underwent excision biopsy (21.5%) in the follow-up time. Conjunctival map biopsy (8%) was performed as an essential tool for excluding the pagetoid spread of SGC. A new reconstruction method named triangular-shaped musculocutaneous tail flap was performed in 33 (11%) patients to reconstruct the moderate eyelid defect following local resection.
Sebaceous gland carcinoma (SGC) was the highest occurrence found to be the highest occurrence among all eyelid malignancies in Bangladesh. SGC is more aggressive and the recurrence rate was higher than BCC and SqCC.
眼睑肿瘤在我们的眼科临床实践中很常见。恶性肿瘤病例仅占所有眼睑肿瘤的四分之一。最具侵袭性的眼睑恶性肿瘤是皮脂腺癌，但在西方国家其发病率较低。我们发现在我们的临床实践中，皮脂腺癌与基底细胞癌一样常见。因此，提高对侵袭性更强的眼睑恶性肿瘤的认识对于降低发病率和死亡率至关重要。
评估孟加拉国人群中眼睑恶性肿瘤的相对发病率，阐述其临床特征及治疗策略的结果，并提高对侵袭性更强的眼睑恶性肿瘤的认识以降低发病率和死亡率。
这是一项对孟加拉国332例患者进行的回顾性病例系列研究。本研究分析了所有经组织学证实的原发性眼睑恶性肿瘤的记录数据，并在2014年至2019年（6年）期间对他们进行了至少6个月的随访。所有患者均通过手术切除治疗，术中在组织病理学检查（冰冻切片或切除活检，切缘有2 - 3毫米正常组织显微镜视野）确认切缘无肿瘤后进行眼睑重建。使用基于计算机的统计软件SPSS进行分析，并采用适当的显著性检验（卡方检验）进行统计分析。
皮脂腺癌（SGC）的发病率最高，为42%，其次是基底细胞癌（BCC），占38%，鳞状细胞癌（SqCC）占18%，恶性黑色素瘤（MM）占2%。SGC、BCC、SqCC和MM的平均发病年龄分别为57.41岁、62.56岁、64.73岁和59.28岁。与其他恶性肿瘤相比，SGC患者中女性（59%）略多于男性（41%）。色素沉着与恶性黑色素瘤（100%）和基底细胞癌（81%）相关。在统计学上，眼睑恶性肿瘤在位置、大小、色素沉着、复发和侵袭性方面存在显著差异。在随访期间，接受冰冻切片活检以清除切缘的患者复发率较低（3%），低于接受切除活检的患者（21.5%）。结膜地图活检（8%）是排除SGC派杰样扩散的重要手段。33例（11%）患者采用一种名为三角形肌皮尾状皮瓣的新重建方法修复局部切除后的中度眼睑缺损。
在孟加拉国，皮脂腺癌（SGC）是所有眼睑恶性肿瘤中发病率最高的。SGC更具侵袭性，复发率高于BCC和SqCC。
