title: Primary intraepithelial sebaceous gland carcinoma of the palpebral conjunctiva.
abstract: Sebaceous gland carcinoma usually arises from meibomian or Zeis glands deep within the eyelid, but it can rarely arise within the conjunctival epithelium without a deep component. We describe a woman with a history of chronic blepharoconjunctivitis unresponsive to topical medications. Examination disclosed confluent papillary hypertrophy of the upper palpebral conjunctiva and deposits of white flaky material. Tarsoconjunctival punch biopsy revealed intraepithelial sebaceous gland carcinoma. Management consisted of frozen section-controlled complete tumor excision with removal of the entire posterior lamella of the right upper eyelid, cryotherapy to the margins, and reconstruction. Histopathologic analysis confirmed primary sebaceous gland carcinoma localized to the conjunctival epithelium without involvement of underlying meibomian or Zeis glands or the caruncle. Patients with unexplained chronic unilateral blepharoconjunctivitis or papillary hypertrophy of the palpebral conjunctiva should be considered for biopsy to rule out neoplasia, even when there is no sign of an underlying eyelid mass.
authors.affiliation: Oncology Service, Wills Eye Hospital, Philadelphia, PA 19107, USA.
authors.forename: S G
authors.initials: SG
authors.lastname: Honavar
authors.forename: C L
authors.initials: CL
authors.lastname: Shields
authors.forename: M
authors.initials: M
authors.lastname: Maus
authors.forename: J A
authors.initials: JA
authors.lastname: Shields
authors.forename: H
authors.initials: H
authors.lastname: Demirci
authors.forename: R C
authors.initials: RC
authors.lastname: Eagle
mesh_terms: D000328:Adult; D001053:Apolipoproteins; D053399:Apolipoproteins D; D015415:Biomarkers; D014408:Biomarkers, Tumor / Q000032:analysis; D002278:Carcinoma in Situ / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D002352:Carrier Proteins / Q000032:analysis; D003230:Conjunctival Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D005260:Female; D006023:Glycoproteins; D006801:Humans; D007633:Keratins / Q000032:analysis; D026901:Membrane Transport Proteins; D018396:Mucin-1 / Q000032:analysis; D009363:Neoplasm Proteins / Q000032:analysis; D012626:Sebaceous Gland Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery
chemical_list: C024328:APOD protein, human; D001053:Apolipoproteins; D053399:Apolipoproteins D; D015415:Biomarkers; D014408:Biomarkers, Tumor; C400901:CAM 5.2 antigen; D002352:Carrier Proteins; D006023:Glycoproteins; D026901:Membrane Transport Proteins; D018396:Mucin-1; D009363:Neoplasm Proteins; D007633:Keratins