Eye
Eyelid adnexal tumors
Sebaceous gland carcinoma of eyelid


Topic Completed: 1 October 2014

Revised: 28 March 2019

Copyright: 2004-2019, PathologyOutlines.com, Inc.

PubMed Search: Sebaceous gland carcinoma [title] of eyelid

Nat Pernick, M.D.
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Cite this page: Pernick N. Eyelid: sebaceous gland carcinoma of eyelid. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/eyeeyelidsebaceouscellcarcinoma.html. Accessed October 17th, 2019.
Definition / general
  • Also called sebaceous cell carcinoma
  • Commonly misdiagnosed as chalazion or chronic blepharoconjunctivitis
  • 1 - 3% of eyelid malignancies in US
  • 75% women, mean age 61 years, range 28 - 82 years
  • 10% are multicentric
  • May arise after radiation therapy for retinoblastoma
  • 1/3 recur, 25% die of metastases (parotid and submandibular nodes), may spread to lacrimal drainage system and nasopharynx
  • Intraepithelial (pagetoid) spread to adjacent structures is common
Poor prognostic factors
  • Orbital or vascular invasion
  • Bilateral involvement of eyelids
  • Poorly differentiated or multicentric tumors
  • Large size
  • Infiltrative pattern
  • Pagetoid spread
Case reports
Clinical images

AFIP images
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Tumor involves upper and lower eyelids

Gross images

AFIP images
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Tumor invading orbit from upper eyelid

Microscopic (histologic) description
  • Nesting, comedonecrosis or papillary patterns
  • Morphology varies from well differentiated to anaplastic
  • Often pagetoid spread or carcinoma in situ
  • Well differentiated:
    • Contain cells with foamy, finely vacuolated cytoplasm and distinct cell borders
    • Better differentiated cells are usually in center of nests, often near tarsus and meibomian glands
  • Anaplastic:
    • Often scant cytoplasm with indistinct vacuoles
    • Central necrosis, pagetoid involvement of overlying skin
Microscopic (histologic) images

AFIP images
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Meibomian glands are replaced by tumor lobules

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Sebaceous differentiation

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Resemble basal cell carcinoma-morphea type

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Pagetoid tumor spread


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Pagetoid tumor spread into eyelid epidermis

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Foamy cytoplasm

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Neoplastic cells replaced conjunctival epithelium

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Neoplastic cells invaded corneal epithelium

Positive stains
Differential diagnosis
Additional references
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