Sebaceous Carcinoma of the Ocular Region

Shields, Jerry A.; Saktanasate, Jarin; Lally, Sara E.; Carrasco, Jacqueline R.; Shields, Carol L.

doi:10.1097/apo.0000000000000105

Cited by 48 publications

(9 citation statements)

References 44 publications

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“…1,2 OASC represents the second most common eyelid malignancy in the United States, accounts for 5% of all eyelid malignancies. 3,4 Sebaceous carcinoma is most frequently seen in the periocular region, with the eyelid and conjunctiva being the most common sites. [5][6][7] Many features contribute to the aggressive clinical course of OASC.…”

Section: Introductionmentioning

confidence: 99%

High expression of PD-1 and PD-L1 in ocular adnexal sebaceous carcinoma

et al. 2018

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Ocular adnexal sebaceous carcinoma (OASC) is an aggressive malignancy that frequently recurs locally and metastasizes. Surgical extirpation may produce significant aesthetic morbidity, and effective systemic therapies for locally advanced or metastatic disease are largely ineffective. Immune checkpoint inhibitors have shown efficacy in the management of several solid tumors where tumor cell PD-L1 expression correlates with improved response. To determine whether OASC might be amenable to immune checkpoint blockade, we performed comprehensive immune profiling for CD3, CD8, PD-1, FOXP3, and PD-L1 in 24 patients with primary OASC. The composition, distribution and density of the tumor associated immune infiltrate were quantified by automated image analysis and correlated with measures of clinical outcome. Tumor cells in 12 OASCs (50%) expressed PD-L1. Higher densities of CD3+ (p = 0.01), CD8+ (p = 0.006), and PD-1+ (p = 0.024) tumor-associated T cells were associated with higher T category (≥T3a per the 7th edition of the American Joint Committee on Cancer staging manual). Higher tumor cell expression of PD-L1 correlated with higher density of PD-1+ tumor-associated T cells (p = 0.021). Since a CD3+ CD8+ PD-1 + T-cell infiltrate represents a "suppressed T-cell phenotype" apparently permissive toward OASC progression, our findings provide a mechanistic rationale for the effective application of immune checkpoint blockade in OASC to abrogate PD-1/PD-L1 interaction and effectively unleash the immune infiltrate to treat higher-stage tumors.

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Section: Introductionmentioning

confidence: 99%

High expression of PD-1 and PD-L1 in ocular adnexal sebaceous carcinoma

et al. 2018

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“…Lymphatic metastasis occurs in 30% of the cases, and the dissemination correlates with tumor location: lower eyelid SC disseminates to submandibular and cervical nodes, while upper eyelid SC affects preauricular and parotid nodes. Distant metastasis frequently affects the lungs, liver, bones, and brain [50].…”

Section: Metastasismentioning

confidence: 99%

Sebaceous Cell Carcinoma: A Persistent Challenge in Clinical and Histopathological Diagnosis

Miyamoto¹,

Wang²

2016

J Clin Exp Dermatol Res

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Sebaceous cell carcinoma continues to defy clinicians and pathologists in terms of early diagnosis. The tumor may be mistaken as benign lesions such as chalazion and blepharitis, and also as malignant neoplasms, mainly basal cell carcinoma and squamous cell carcinoma. Despite advances in immunohistochemical analysis and treatment options during the last decades, morbidity and metastasis rates remain high. Prognosis is strongly related to the length of time between diagnosis and initiation of treatment, which reinforces the importance of early recognition of this condition. This article reviews key features of sebaceous cell carcinoma, from epidemiology to treatment, and new strategies to improve outcome.

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“…SGC may masquerade as recurrent chalazion or chronic blepharitis. e incidence of metastasis is high in SGC, and it may have a pagetoid/multicentric pattern [23][24][25]. Adverse prognostic features include involvement of the upper eyelid, a tumour size of 10 mm or more, and a duration of symptoms of over six months.…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological Analysis and Surgical Outcome of Eyelid Malignancies: A Study of 332 Cases

Kadir¹,

Mitra

Rashid³

et al. 2022

Journal of Skin Cancer

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Background. Eyelid tumours are common in our ophthalmic practice. Malignancy cases account only for one-fourth of all eyelid tumours. The most aggressive eyelid malignancy is sebaceous gland carcinoma, but its occurrences are rare in western countries. We found sebaceous gland carcinoma is as common as basal cell carcinoma in our clinical practices. Hence, it is essential to build awareness about the more aggressive eyelid malignancies to reduce morbidity and mortality. Aim. To assess the relative frequency of eyelid malignancies in the Bangladesh population, state their clinical features and outcome of management strategies and build awareness about the more aggressive eyelid malignancies to reduce morbidity and mortality. Methods. This was a retrospective case series study of 332 patients in Bangladesh. This study analyzed all the recorded data of the histologically proven primary eyelid malignancies and followed them up for at least six months from 2014 to 2019 (6 years). All patients were managed by surgical excision with tumor-free margins verified on histopathology, either the frozen section or excision biopsy with 2–3 mm microscopic view of normal tissue followed by eyelid reconstruction. Computer-based statistical software SPSS was used for the analysis, and an appropriate test of significance (chi-square) was used for the statistical analysis. Results. Sebaceous gland carcinoma (SGC) was the highest in occurrence, at 42%, followed by 38% basal cell carcinoma (BCC), 18% squamous cell carcinoma (SqCC), and 02% malignant melanoma (MM). The mean age at presentation of SGC, BCC, SqCC, and MM were 57.41 years, 62.56 years, 64.73 years, and 59.28 years, respectively. Female (59%) was slightly more preponderance over the male (41%) for SGC than other malignancies. Pigmentation was associated with malignant melanoma (100%) and BCC (81%). Statistically, a significant difference was found between eyelid malignancies, including location, size, pigmentation, recurrence, and invasiveness. The recurrence rate was low lower in the patients who underwent frozen section biopsy (3%) for margin clearance than those who underwent excision biopsy (21.5%) in the follow-up time. Conjunctival map biopsy (8%) was performed as an essential tool for excluding the pagetoid spread of SGC. A new reconstruction method named triangular-shaped musculocutaneous tail flap was performed in 33 (11%) patients to reconstruct the moderate eyelid defect following local resection. Conclusion. Sebaceous gland carcinoma (SGC) was the highest occurrence found to be the highest occurrence among all eyelid malignancies in Bangladesh. SGC is more aggressive and the recurrence rate was higher than BCC and SqCC.

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Sebaceous Carcinoma of the Ocular Region

Cited by 48 publications

References 44 publications

High expression of PD-1 and PD-L1 in ocular adnexal sebaceous carcinoma

High expression of PD-1 and PD-L1 in ocular adnexal sebaceous carcinoma

Sebaceous Cell Carcinoma: A Persistent Challenge in Clinical and Histopathological Diagnosis

Clinicopathological Analysis and Surgical Outcome of Eyelid Malignancies: A Study of 332 Cases

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