Chang Kenneth, Wileman Justin M, Gabbard Ryan D, Woodard Ryan J, Patel Rakesh M, Iverson Shawn M
University of South Carolina/Prisma Health, Columbia, SC, USA.
University of South Carolina School of Medicine, Columbia, SC, USA.
Am J Ophthalmol Case Rep. 2022 Jul 31;27:101675. doi: 10.1016/j.ajoc.2022.101675. eCollection 2022 Sep.
To report a rare case of primary sebaceous gland carcinoma of the bulbar conjunctiva without palpebral involvement.
A 76-year-old male was referred to the cornea service for a suspicious lesion on the limbal conjunctiva and cornea of his left eye. On exam, there was a large fibrovascular growth with conjunctivalization of the cornea from 2:00 to 10:00 extending 6mm onto the cornea. Patient underwent treatment with 5-fluouracil, followed by excisional biopsy with cryotherapy. Histopathologic examination demonstrated poorly differentiated sebaceous gland carcinoma. Subsequent map biopsies of the palpebral and bulbar conjunctiva of the left eye were performed and ruled out pagetoid spread.
Primary sebaceous gland carcinoma of the bulbar conjunctiva without eyelid involvement is a rare phenomenon. Our patient joins a few case reports in the literature. Of these cases, we are the second case to utilize 5-flurouracil preoperatively. We recommend clinicians consider sebaceous carcinoma on their differential when ocular surface neoplasms diagnosed as other conditions do not respond to conventional therapies.
报告1例罕见的原发性球结膜皮脂腺癌，未累及睑结膜。
一名76岁男性因左眼角膜缘结膜和角膜上的可疑病变被转诊至角膜科。检查发现，有一个大的纤维血管性肿物，角膜从2点至10点出现结膜化，向角膜延伸6mm。患者接受了5-氟尿嘧啶治疗，随后进行了切除活检及冷冻治疗。组织病理学检查显示为低分化皮脂腺癌。随后对左眼睑结膜和球结膜进行了地图活检，排除了佩吉特样扩散。
原发性球结膜皮脂腺癌不累及眼睑是一种罕见现象。我们的患者加入了文献中的少数病例报告。在这些病例中，我们是第二例术前使用5-氟尿嘧啶的病例。我们建议临床医生在诊断为其他疾病的眼表肿瘤对传统治疗无反应时，在鉴别诊断中考虑皮脂腺癌。
