Wolfe J T, Yeatts R P, Wick M R, Campbell R J, Waller R R
Am J Surg Pathol. 1984 Aug;8(8):597-606. doi: 10.1097/00000478-198408000-00003.
Sebaceous carcinoma of the eyelid is commonly misdiagnosed because it simulates other entities both clinically and pathologically. In a review of all pathologic material removed from the eyelids of patients at the Mayo Clinic between 1905 and 1981, 43 sebaceous carcinomas were discovered. The tumors manifested most frequently on the upper eyelid; the onset of symptoms occurred in 31 women and 12 men at a mean age of 61.5 years (range, 28-82 years). Of the 43 patients, 11 had an associated second malignant tumor or exposure to irradiation. The microscopic diagnosis was based on finding a proliferation of basophilic neoplastic cells with foamy cytoplasm and a positive fat stain. Intraepithelial neoplasia in the form of pagetoid change or carcinoma in situ was found in more than 80% of cases. Histologically, the tumor tended to be moderately differentiated. A high degree of infiltration was frequently observed cases with metastases. When intraepithelial neoplasia is observed microscopically, we recommend a fat stain on a frozen section and a full-thickness eyelid biopsy to exclude sebaceous carcinoma.
眼睑皮脂腺癌常被误诊，因为它在临床和病理上都与其他病变相似。回顾1905年至1981年间梅奥诊所从患者眼睑切除的所有病理材料，发现了43例皮脂腺癌。肿瘤最常出现在上眼睑；症状出现时，31名女性和12名男性的平均年龄为61.5岁（范围28 - 82岁）。43例患者中，11例伴有第二种恶性肿瘤或曾接受过放射治疗。显微镜诊断基于发现嗜碱性肿瘤细胞增殖，胞质呈泡沫状，脂肪染色阳性。超过80%的病例发现有派杰样改变或原位癌形式的上皮内瘤变。组织学上，肿瘤倾向于中度分化。有转移的病例常观察到高度浸润。当显微镜下观察到上皮内瘤变时，我们建议对冰冻切片进行脂肪染色，并进行全层眼睑活检以排除皮脂腺癌。
