title: Epidemiology and Prognosis of Primary Periocular Sweat Gland Carcinomas.
abstract: OBJECTIVE
  To characterize the clinical presentation, management, and outcomes of patients with sweat gland carcinoma of the periocular region. To review the pathologic classification scheme, compare the clinical behavior between subtypes, and discuss treatment recommendations for periocular sweat gland carcinomas.
  
  
  METHODS
  Retrospective study from 2 tertiary centers, which are part of the American Society of Ophthalmic Plastic and Reconstructive Surgery Oncology Database.
  
  
  RESULTS
  Twenty-two patients, of whom 13 (59%) were female, were included in the study. The median age was 69 years. The median follow-up time was 23 months. Twenty (91%) patients had lesions that were slow growing and were present for several months to years before diagnosis. Presentation was varied, and pathology included mucinous carcinoma (7; 32%), microcystic adnexal carcinoma (4; 18%), endocrine mucin-producing sweat gland carcinoma (4; 18%), eccrine carcinoma (2; 9%), apocrine carcinoma (2; 9%), poorly differential adnexal carcinoma (2; 9%), and hidroadenocarcinoma (1; 5%). Microcystic adnexal carcinoma tended to present with the largest tumor dimension (range: 25-32 mm) and mucinous carcinoma the smallest (range: 5-13 mm). Treatments included Mohs micrographic excision in 10 patients (45.5%), wide local excision in 10 patients (45.5%), and orbital exenteration in 2 patients (9%). No lesions ≤T2b (by AJCC 7th edition classification for eyelid carcinomas) had local recurrence or nodal metastasis. No patients had distant metastasis.
  
  
  CONCLUSIONS
  Sweat gland carcinomas tend to grow slowly and be present for several months to years before diagnosis. Overall, microcystic adnexal carcinoma subtype showed more aggressive clinical behavior than mucinous subtypes. Eyelid carcinomas AJCC category T2b or less were associated with better outcomes.
authors.affiliation: *Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Iowa City, Iowa; †Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, and ‡Department of Pathology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, U.S.A.
authors.forename: Meredith S
authors.initials: MS
authors.lastname: Baker
authors.forename: Vivian T
authors.initials: VT
authors.lastname: Yin
authors.forename: Doina
authors.initials: D
authors.lastname: Ivan
authors.forename: Richard C
authors.initials: RC
authors.lastname: Allen
authors.forename: Keith D
authors.initials: KD
authors.lastname: Carter
authors.forename: Bita
authors.initials: B
authors.lastname: Esmaeli
authors.forename: Erin M
authors.initials: EM
authors.lastname: Shriver
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D005142:Eyelid Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery; D009362:Neoplasm Metastasis / Q000473:pathology; D009364:Neoplasm Recurrence, Local; D013508:Ophthalmologic Surgical Procedures / Q000379:methods; D009918:Orbital Neoplasms / Q000473:pathology; D012189:Retrospective Studies; D013544:Sweat Gland Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D014481:United States / Q000453:epidemiology