title: Management Considerations in Extraocular Sebaceous Carcinoma.
abstract: BACKGROUND
  Extraocular sebaceous carcinoma (SC) is a rare malignancy with metastatic potential. The authors present a case of a rapidly growing extraocular SC with equivocal radiographic imaging to highlight challenges in tumor management.
  
  
  OBJECTIVE
  To examine the existing literature for evaluation and management recommendations of extraocular SC.
  
  
  METHODS
  A comprehensive review of relevant English articles in PubMed through May 2015.
  
  
  RESULTS
  Tumor-specific staging system and management guidelines do not currently exist for extraocular SC. Mohs micrographic surgery or wide local excision are the most commonly used surgical treatments. Regional/distant metastasis occurs infrequently, but systemic workup with radiographic imaging or sentinel lymph node biopsy may be warranted in select cases. Adjuvant radiation therapy can be considered for recurrent and metastatic tumors.
  
  
  CONCLUSIONS
  Extraocular SCs present unique challenges that may benefit from multidisciplinary management. Surgical removal with negative pathologic margins is the mainstay treatment of extraocular SC. Additional studies will help clarify the optimal diagnostic workup and adjuvant treatment of patients.
authors.affiliation: *Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania; †Division of Dermatologic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania; ‡Department of Otorhinolaryngology, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Aileen Y
authors.initials: AY
authors.lastname: Chang
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Miller
authors.forename: Rosalie
authors.initials: R
authors.lastname: Elenitsas
authors.forename: Jason G
authors.initials: JG
authors.lastname: Newman
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Sobanko
mesh_terms: D018266:Adenocarcinoma, Sebaceous / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D015580:Mohs Surgery; D055653:Muir-Torre Syndrome / Q000473:pathology; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000473:pathology; D011379:Prognosis; D011859:Radiography; D018714:Radiotherapy, Adjuvant; D012626:Sebaceous Gland Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D021701:Sentinel Lymph Node Biopsy