Maniglia A J
Laryngoscope. 1978 Sep;88(9 Pt 1):1421-6. doi: 10.1002/lary.1978.88.9.1421.
Meibomian sebaceous gland adenocarcinoma of the eyelid is a rare lethal neoplasm. It accounts for less than 1% of all eyelid tumors. There are approximately 200 cases described in the literature. The incidence of regional metastases is 17-28%. Once metastases are present, only half of the patients survive five years. Presented are two cases with neck node metastases. In one of the patients the primary lesion was initially treated with radiation therapy with an unsuccessful result. Subsequently full thickness, wide excision of the lower lid was required to control the primary. Eyelid oculoplastic reconstruction was performed using a masolabial rotation skin flap lined with nasal septal composite graft (cartilage and mucosa). Orbital exenteration was necessary to control the primary tumor in the other patients. The regional metastases in both patients were treated with parotidectomy with preservation of the facial nerve, radical neck dissection and postoperative radiation therapy. One of the patients with poorly differentiated adenocarcinoma died due to brain metastasis. I feel that combined treatment of radical surgery to the primary site, parotidectomy, radical neck dissection and planned postoperative radiation therapy may improve the five-year survival of patients with regional node metastases.
眼睑睑板腺癌是一种罕见的致命性肿瘤。它占所有眼睑肿瘤的比例不到1%。文献中描述的病例约有200例。区域转移的发生率为17% - 28%。一旦出现转移，只有一半的患者能存活五年。本文介绍了两例伴有颈部淋巴结转移的病例。其中一名患者的原发灶最初接受放射治疗，但效果不佳。随后需要对下睑进行全层广泛切除以控制原发灶。采用鼻中隔复合移植（软骨和黏膜）衬里的鼻唇沟旋转皮瓣进行眼睑眼部整形重建。另一名患者则需要进行眶内容剜除术以控制原发肿瘤。两名患者的区域转移均采用保留面神经的腮腺切除术、根治性颈清扫术和术后放射治疗。其中一名低分化腺癌患者因脑转移死亡。我认为对原发部位进行根治性手术、腮腺切除术、根治性颈清扫术以及计划好的术后放射治疗的联合治疗可能会提高伴有区域淋巴结转移患者的五年生存率。
