A Case Report of Recurrent Metastatic Sebaceous Carcinoma Which Showed Favorable Response Tt Non-Fluorouracil Based Chemotherapy

Treatment of Malignant Adnexal Tumors of the Skin: A 12-Year Perspective

Malignant adnexal cancers of the skin—extremely rare neoplasms—are mostly reported as non-symptomatic, slow-growing nodules. These carcinomas occur mainly in the middle-aged (50–60 years of age); they are mostly localized on the upper part of the body and are locally aggressive, infiltrate surrounding tissue, and metastasize to regional lymph nodes. The patients’ outcomes depend on multiple prognostic factors, including the size of the primary tumor and its mitotic count. Surgical resection of the primary tumor with or without regional lymph nodes is the treatment method of choice; however, due to aggressive tumor behavior, perioperative treatment may be considered. The role and efficacy of radiotherapy in the treatment of skin adnexal malignancies are not yet fully defined. Some authors suggest that adjuvant radiotherapy may be considered in locally advanced and regional disease. The aim of this study was to evaluate treatment outcomes and assess the efficacy of combined therapy in patients with adnexal malignancies. Our analysis covered all cases of cutaneous adnexal tumor patients diagnosed and provided with multidisciplinary treatment with surgery and radiotherapy since the beginning of 2009.

Left Buttock Sebaceus Carcinoma: A Case Report and Review of the Literature

Sebaceous carcinoma is a rare, aggressive, malignant tumour, characterized by a tendency for local recurrence and distant metastases. This case report presents a rare form of sebaceous carcinoma in an 86 years-old female. Clinical examination revealed a 12cm nodular tumour, yellow-brown in colour, located on the left buttock of the patient. Ultrasound examination indicated that no ganglions were affected; dermatological examination suggested that the tumour had an unpredictable evolution. Treatment was surgical with a 2cm wide excision, followed by reconstruction with a VY skin flap, from the left side of the buttock. Histological exam supported the diagnosis of sebaceous carcinoma; the tumour was removed with a safety margin of healthy tissue. Sebaceous carcinoma is a malignant tumour with unpredictable evolution. Diagnosis is based on histological examination. Treatment of choice consists in complete wide surgical excision.

Management of recurrent sebaceous gland carcinoma

OBJECTIVE

To evaluate the incidence and management of recurrent periocular sebaceous gland carcinoma at a tertiary ocular oncology service in the United Kingdom.

METHODS

This was a retrospective cohort study of 62 patients with sebaceous gland carcinoma treated between 2004 and 2017. A total of 10 eyes were treated for local recurrence. The following variables were recorded: age and sex of patient; tumour location, histological subtype; recurrence type; treatment and outcome.

RESULTS

Of the 62 cases with eyelid SGC, 10 (16%) had recurrences during the study period and satisfied inclusion criteria. There were six (60%) females and four males in the recurrent group. The mean time interval between initial excision and tumour recurrence was 37 months (median 23 months; range 4 to 84 months). Four patients received cryotherapy to the lids and conjunctiva to control recurrent disease and two patients were treated with topical or intralesional chemotherapy. Four patients (40%) underwent orbital exenteration during the study period. Metastasis occurred in 20% over a mean follow-up of 113 months (median 106; range 47-184 months).

CONCLUSIONS

The risk factors for local recurrence of SGC after wide excision with paraffin section control were reported, and an approach to these recurrent lesions was proposed. The results of this study will help guide surgeons dealing with the medical and surgical conundrum of recurrent disease. The risk of recurrence is highest in the first 2 years after initial excision.