Sebaceous Gland Carcinoma
Sebaceous gland carcinoma accounts for approximately 1% of all eyelid tumors and 5% of eyelid malignancies. It usually occurs in older individuals but may be seen in younger persons after radiation therapy. These tumors may masquerade as chalazia or as chronic unilateral blepharoconjunctivitis (Fig 12-7). Consequently, more than 50% of cases are initially misdiagnosed. Epithelial invasion of the conjunctiva occurs in almost 50% of cases and extends onto the cornea in more than 25% of cases. For further discussion, see BCSC Section 7, Oculofacial Plastic and Orbital Surgery.
Figure 12-7 Sebaceous gland carcinoma: various presentations. A, Presents as a unilateral blepharoconjunctivitis with injection, pannus, thickened eyelid margin, and eyelash loss. B, White nodules composed of neoplastic sebaceous cells may be present near the limbus. C, Neoplastic symblepharon is present nasally. D, Upper palpebral conjunctival thickening. Papillary fronding may be present.
(Reproduced with permission from Mannis MJ, Holland EJ, eds. Cornea. Vol 1. 4th ed. Philadelphia: Elsevier; 2017:422.)
Shields JA, Demirci H, Marr BP, Eagle RC Jr, Shields CL. Sebaceous carcinoma of the eyelids: personal experience with 60 cases. Ophthalmology. 2004;111(12):2151–2157.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.