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Volume 27, Issue 138, August 2023

An advanced Sebaceous Gland Carcinoma of the eyelid: A rare case report

Rahul Rajendran¹, Bhushan Jajoo², Raju Shinde³, Firoz Borle⁴, Tejashree Telkhade⁵, Hard Tilva⁶

¹Junior Resident, Department of General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi, Wardha, Maharashtra, India
²Assistant Professor, Department of Surgical oncology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi, Wardha, Maharashtra, India. Email: jajoobhushan@gmail.com
³Professor, Department of General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi, Wardha, Maharashtra, India
⁴Assistant Professor, Department of Plastic Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi, Wardha, Maharashtra, India
⁵Assistant Professor, Department of Radio Oncology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi, Wardha, Maharashtra, India
⁶Junior Resident, Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi, Wardha, Maharashtra, India

ABSTRACT

Sebaceous gland carcinoma (SGC) of the eyelid is an extremely lethal tumor if left untreated due to its extensive capacity to infiltrate surrounding tissue and metastasize. We hereby report a case of a 60-year-old male who presented with an ulcerative lesion over the left eye involving both eyelids and complete loss of vision for 1 year. CECT head and neck are suggestive of heterogeneously enhancing soft tissue density lesion with areas of necrosis within it seen in the left periorbital region. The lesion is causing erosive destruction of the lateral wall of the left orbit and involving the extra and intraconal compartment with ipsilateral enlarged parotid and cervical lymph nodes. Eyelid biopsy confirmed diagnosis of sebaceous carcinoma. The case was discussed in the Tumor board, and was advised upfront surgery. The patient underwent left extended orbital exenteration with left total parotidectomy, ipsilateral modified radical neck dissection and free anterolateral thigh flap reconstruction. Post-operative histopathology suggests SGC with parotid nodes and level IB, IIA lymph nodes positive for metastasis. Postoperatively patient underwent adjuvant radiotherapy. The patient is currently under regular follow-up and is disease free.

Keywords: Sebaceous gland carcinoma (SGC), Eyelid, Orbital exenteration, Modified radical neck dissection (MRND), Free anterolateral thigh flap