• Ocular Pathology/Oncology, Oculoplastics/Orbit

    Review of: Pagetoid tumour spread in periocular sebaceous gland carcinoma: A comparative analysis in 130 patients

    Kaliki S, Morawala A, Dharap R, et al. Eye (London), October 2021

    Investigators in India conducted a study to compare the clinical and histopathologic features and prognosis of patients with periocular sebaceous gland carcinoma (SGC) with and without pagetoid tumor spread.

    Study design

    This was a retrospective, comparative study of 130 patients with SGC who underwent 17-site conjunctival map biopsy.

    Outcomes

    A total of 23% of patients had pagetoid tumor spread. Each 1-mm increase in tumor basal diameter increased the odds of pagetoid tumor spread by 13% (odds ratio 1.13). Globe salvage was 95% in patients without pagetoid spread and 33% in patients with pagetoid spread. Five-year rates of systemic metastasis and death were 21% and 28%, respectively, in patients with pagetoid spread; the rates were and 4% and 4%, respectively, in patients without pagetoid spread, though these differences were not statistically significant.

    Limitations

    Although this is a large SGC study compared with others in the literature, the numbers are still not great enough to provide statistically significant differences for risks of metastasis and death between patients with and without pagetoid spread.

    Clinical significance

    Sebaceous gland carcinoma is a difficult malignancy to treat. This study shows that greater tumor basal diameter can predict the risks of pagetoid tumor spread. Map biopsies are recommended in all patients with SGC to detect pagetoid spread. Globe salvage is shown to be worse when pagetoid spread is present.