Purchase this article with an account.
Eva Janine Becker, Martina C Herwig, Frank G Holz, Hans-Peter Fischer, Karin U Loeffler; Sebaceous gland carcinoma of the ocular adnexa - variability in histological and immunhistochemical appearance. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5433.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate the characteristics of sebaceous gland carcinoma (SGC) of the ocular adnexae which is - due to a high variability in clinical, histological and immunhistochemical characteristics - challenging to diagnose.
Records of 6 patients (1 female, 5 male) with SGC were reviewed, who underwent surgical excision and who were histologically diagnosed SGCs. For comparison, specimens from 4 patients with basal cell carcinoma (BCC), 1 with squamous cell carcinoma (SCC) and 2 with indeterminate lesions were examined. Histological and immunhistochemical analysis included stains for HE and PAS, cytokeratins (CKpan, Cam5.2), epithelial membrane antigen (EMA), androgen receptor (AR441), and adipophilin.
SGCs were located in the upper (n=2) or lower (n=4) eyelid and were associated with various clinical signs including chalazion-like lesions with pyogenic granuloma (n=1), papillomatous conjunctival tumors (n=3), a hyperkeratotic exophytic neoplasm (n=1) and an ulcerating crusted lesion resembling chronic blepharitis (n=1). The treatment was tumor resection, followed (if necessary) by adjuvant therapy with topical Mitomycin C (n=2). Histologic characteristics included basophilic pleomorphic cells with vacuolated cytoplasm, prominent nucleoli, mitotic figures and in some cases pagetoid spread (n=2). CKpan, EMA and Cam5.2 showed a strong positive immunoreactivity in all specimens (SGC, BCC, SCC). AR441 positivity was noted with variable intensities in almost all lesions and in particular in pagetoid spread in contrast to non-tumor cells. Adipophilin showed an annular staining of lipid granules in immature sebaceous cells and was mainly found in SGC.
SGCs display a variety of clinical signs and may mimic many other lesions. Tumor resection, followed by histological and immunhistochemical analysis, leads to the diagnosis and initiation of the proper treatment regimen. Herein, immunohistochemistry showed an unequivocal profile in SGC and did not allow for an exact differentiation from BCC and SCC by immunohistochemical means only. An extended evaluation of HE stains remains essential. However, immunohistochemistry can make relevant contributions to the diagnosis of SGC, especially in cases of inconclusive histology, by positive staining for adipophilin in immature sebaceous cells or by AR441 labeling in cases of pagetoid spread.
This PDF is available to Subscribers Only