Sebaceous carcinoma of the eyelid is one of the common malignant tumors of the eyelid. It generally occurs in middle-aged and elderly individuals, with a peak incidence around 60 years of age. The upper eyelid is the most frequently affected site, and the tumor often originates from the Meibomian glands or the glands of Zeis. When arising from the Meibomian glands, the tumor initially presents as a small subcutaneous nodule in the eyelid, resembling a chalazion and is therefore easily misdiagnosed. As the lesion enlarges, it may cause a diffuse, plaque-like thickening of the tarsal plate, with the corresponding palpebral conjunctiva showing a yellowish elevation. In cases originating from the glands of Zeis, the tumor typically appears as a yellowish nodule at the eyelid margin with normal overlying skin. Some tumors display Pagetoid infiltration, mimicking conjunctivitis and leading to potential misdiagnosis. Sebaceous carcinoma is highly malignant, with potential for orbital extension and both regional and distant metastasis. Poor prognostic factors include orbital invasion, Pagetoid spread, and perineural invasion.
Figure 1 Sebaceous carcinoma of the left eyelid
A yellowish-white mass is visible on the palpebral conjunctiva, accompanied by abundant secretions, ulceration, and bleeding.
Treatment
Surgical treatment is the primary approach. For localized lesions, surgical excision with margin control using cryotherapy offers a favorable prognosis. However, if the tumor has invaded adjacent tissues, postoperative recurrence is relatively common.