title: Locally advanced sebaceous cell carcinoma (T3) of eyelid: incidence and pattern of nodal metastases and combined modality management approach.
abstract: BACKGROUND
  Sebaceous carcinoma (SbCC) is a rare malignancy that often mimics benign conditions. Lymphatic involvement, large T3 tumors herald a dismal survival for patients. We present our series of 13 cases of locally advanced SbCC of the eyelid treated at a surgical oncology unit and describe the clinical profile, patterns of nodal spread and recurrence pattern in this subset of SbCC.
  
  
  METHODS
  A retrospective analysis of case records was carried out for patients presenting with orbital tumors between January 1997 and April 2010 in the department of Surgical Oncology, AIIMS, New Delhi, India. All patients underwent orbital exenteration and superficial parotidectomy with neck dissection was added to patients with clinically significant lymphadenopathy. All patients who underwent OE after 2002 were advised radiotherapy as adjuvant therapy. The end point was development of recurrence or end of two year follow up period which ever occurred earlier.
  
  
  RESULTS
  Thirteen patients underwent orbital exenteration. Eleven patients had clinically palpable lymphadenopathy. Ten patients (76.9%) had pathologically confirmed metastatic nodes. Parotid lymph node involvement was present in all patients (100%); two of these ten patients also had level II b cervical lymph node involvement. Recurrence was observed in seven patients (53.8%). All recurrences were loco-regional only and no systemic metastases was seen. There were only two recurrences in the group that received PORT.
  
  
  CONCLUSIONS
  Eyelid SbCC is a loco-regionally aggressive malignancy and adequate disease control can be achieved with combined modality approach of radical surgery followed by post operative radiotherapy.
authors.affiliation: Department of Surgical Oncology, Dr BR Ambedkar Institute Rotary cancer Hospital, All India Institute of Medical Sciences, Delhi, India.
authors.forename: S V S
authors.initials: SV
authors.lastname: Deo
authors.forename: Nootan Kumar
authors.initials: NK
authors.lastname: Shukla
authors.forename: Mandeep
authors.initials: M
authors.lastname: Singh
authors.forename: Deepak
authors.initials: D
authors.lastname: Jha
authors.forename: Paras
authors.initials: P
authors.lastname: Khanna
authors.forename: Ashwin
authors.initials: A
authors.lastname: Kallianpur
mesh_terms: D018266:Adenocarcinoma, Sebaceous / Q000453:epidemiology / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D017234:Eye Evisceration; D005142:Eyelid Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D006801:Humans; D015994:Incidence; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000532:radiotherapy / Q000601:surgery; D010306:Parotid Gland; D012189:Retrospective Studies; D012626:Sebaceous Gland Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery