Sebaceous Gland Carcinoma
Introduction:-
This is a very aggressive skin cancer, grows very slowly and is more commonly found in the elderly population. The disease originates in the Meibomian gland, glands of Zeis, Sebaceous glands of the eyebrowscaruncle related glands, and Glands of the fine hair follicles of the eyelid.
Alternative nomenclature:-
- Sebaceous Carcinoma
- SGC
Epidemiology:-
- This is a very rare cancer.
- It is more common in Asian populations.
- It affects more women, about 57%, in comparison to men and usually people in their 60s and 70s.
This carcinoma is one that has relatively high metastasis (distant spread) possibility and is therefore far more dangerous to life than basal cell or squamous cell cancers.
Causes and Risk Factors:-
- Exposure to high levels of radiation
- It is associated with a specific health condition called Muir Torre Syndrome – with other cancers present else where in the body.
Symptoms and Signs:-
They appear as hard painless nodules, mainly appearing in the eyelid and are frequently mistaken for other conditions like chalazion.
Investigations:-
- It is usually slow growing.
- 1 in 5 cases usually metastatises elsewhere in the body
Diagnosis:-
- Due to its varied clinical appearance the diagnosis is usually delayed for it is mistaken for many benign entities.
- Biopsy is necessary as soon as possible, for this carcinoma is very aggressive.
Complications of Disease:-
Metastasis is the most common complication.
Treatment Options:-
- Surgical removal of the carcinoma is the first choice. Even if the first choice was radiotherapy, after the metastasis the doctor most certainly will proceed with surgical removal.
- Radiotherapy is used in cases surgical removal is not possible due to the difficult location of the tumor.
Medical Management:-
Surgical care:
Healthy tissue must be removed together with cancer tissue (i.e. margins should be clear) to ensure that no metastasis will take place.
Complications of Treatment:-
- Complications of medical management:The use of radiotherapy may create additional health problems.
- Complications of surgical care:Due to the usual location of the carcinoma which is the eyelid and the area around the eye, the removal of tissue may create some aesthetic problems as well as eyelid problemsand problems in movement of the eye muscles.
Prognosis:-
- Mortality rate is high, around 5-10% due to the difficulties in diagnoses, metastasis as well as treatment.
- If the patient does not approach a physician within 6 months from the presentation of the symptoms, the mortality rises to 38%.
Prevention:-
This kind of disease cannot be prevented for the source is not fully understood nor determined.
