Zürcher M, Hintschich C R, Garner A, Bunce C, Collin J R
Augenklinik, Kantonsspital Luzern, Switzerland.
Br J Ophthalmol. 1998 Sep;82(9):1049-55. doi: 10.1136/bjo.82.9.1049.
Sebaceous carcinoma of the eyelid is rare. The diagnosis might be difficult because of its ability to masquerade as other periocular lesions. Prognosis is still regarded as being poor compared with most other malignant eyelid tumours with a mortality second only to malignant melanoma. The present study retrospectively analyses clinical and histopathological findings and outcome in a series of patients with sebaceous carcinoma of the eyelid in Britain.
43 patients with histologically confirmed sebaceous carcinoma treated at Moorfields Eye Hospital between 1976 and 1992 were subjected to retrospective analysis. Clinical data of all patients were reviewed from the charts; all surviving patients except four cases lost for follow up were re-examined. Histological specimens were reviewed in 41 cases.
23 females and 20 males, mean age 63 years (range 37-79), were treated. Primary therapy was surgery in 37 and radiotherapy in six cases. After a median follow up of 40 months (range 1-148) 30 patients were alive without recurrences, four patients had died from the tumour, and one was alive with local recurrence and distant metastases. Four patients had died of non-tumour related causes. Histologically, unfavourable outcome was correlated with poor tumour differentiation and extensive invasion.
Early diagnosis and consequent surgical therapy of sebaceous carcinoma of the eyelid leads to a better outcome and higher survival rates than generally assumed. Even local recurrences can be treated successfully. However, sebaceous carcinoma remains a threatening disease, which leads to death in 9% and to mutilating exenteration in 23% of our patients.
眼睑皮脂腺癌较为罕见。因其可伪装成其他眼周病变，故诊断可能存在困难。与大多数其他恶性眼睑肿瘤相比，其预后仍被认为较差，死亡率仅次于恶性黑色素瘤。本研究回顾性分析了英国一系列眼睑皮脂腺癌患者的临床和组织病理学 findings 以及结局。
对1976年至1992年间在穆尔菲尔兹眼科医院接受治疗的43例经组织学确诊的皮脂腺癌患者进行回顾性分析。从病历中查阅了所有患者的临床资料；除4例失访的存活患者外，对所有存活患者进行了复查。对41例患者的组织学标本进行了复查。
共治疗23例女性和20例男性，平均年龄63岁（范围37 - 79岁）。主要治疗方法为手术治疗37例，放射治疗6例。中位随访40个月（范围1 - 148个月）后，30例患者存活且无复发，4例患者死于肿瘤，1例患者存活但有局部复发和远处转移。4例患者死于非肿瘤相关原因。组织学上，不良结局与肿瘤分化差和广泛浸润相关。
眼睑皮脂腺癌的早期诊断及随之而来的手术治疗可带来比一般认为更好的结局和更高的生存率。即使是局部复发也可成功治疗。然而，皮脂腺癌仍然是一种具有威胁性的疾病，在我们的患者中，9%导致死亡，23%导致毁容性眼球摘除术。
