Folberg R, Whitaker D C, Tse D T, Nerad J A
Am J Ophthalmol. 1987 Jun 15;103(6):817-23. doi: 10.1016/s0002-9394(14)74400-9.
We reviewed the histories of three patients with sebaceous carcinoma (two of the eyelid and one of the caruncle) who had had their tumors excised by surgeons experienced in the Mohs' technique. In each patient the tumor was considered totally excised. In one patient, residual intraepithelial pagetoid sebaceous carcinoma of the eyelid was detected incidentally when a reparative flap was placed. In the other two patients, invasive sebaceous carcinoma recurred, necessitating orbital exenteration; one patient has regional lymph node metastases. Because of the difficulty in detecting pagetoid spread on frozen sections and the multicentric nature of sebaceous carcinoma, we advocate managing these tumors by wide local excision, checking margins with high-quality permanent sections.
我们回顾了3例皮脂腺癌患者（2例发生于眼睑，1例发生于泪阜）的病史，这些患者的肿瘤均由精通莫氏手术技术的外科医生切除。每位患者的肿瘤均被认为已完全切除。其中1例患者，在进行修复皮瓣移植时偶然发现眼睑残留上皮内派杰样皮脂腺癌。另外2例患者，浸润性皮脂腺癌复发，需要进行眼眶内容剜除术；1例患者出现区域淋巴结转移。由于在冰冻切片上难以检测到派杰样扩散以及皮脂腺癌的多中心性质，我们主张通过广泛局部切除来处理这些肿瘤，并用高质量的永久切片检查切缘。
