Histopathological review of sebaceous carcinoma of the eyelid

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Abstract
Sebaceous carcinoma of the eyelid can clinically mimic benign conditions, such as recurrent chalazion and inflammation and histopathologically squamous cell and basal cell carcinoma (BCC). This retrospective study was undertaken as an attempt to improve the characterization and consequently the diagnosis of these tumors. Retrospective analysis was performed on eyelid specimens diagnosed as sebaceous carcinoma retrieved from Henry C. Witelson Ophthalmic Pathology Registry, Canada and Hospital Luis S. Bulnes Pathology Registry, Mexico. Two independent, masked pathologists reviewed the H&E microslides. Forty-four cases were retrieved, 31 from Canada and 13 from Mexico. Cytoplasmic vacuoles were observed in 48% of the cases. Eighty-four percent of the cases were classified as poorly differentiated lesions. Of these, 75% had features similar to squamous cell carcinoma (SqCC), some with dyskeratosis (30%) and 7% resembled BCC. Solid growth pattern was seen in 26.2% of the cases and lobular growth pattern in 26.2%. Superficial spread resembling Bowen-like disease was observed in 33% of the cases, pagetoid features in 33% and comedocarcinoma in 31.8%. Sebaceous carcinoma presented as a poorly differentiated lesion in most cases of this series, which suggests a possibility of misdiagnosis because of its similarities to SqCC.