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Taylor Nayman, Pablo Zoroquiain, Evangelina Esposito, Sabrina Bergeron, Carlos Augusto Moreira Neto, Sultan Aldrees, Miguel N Burnier; Clinicopathologic features of basal cell carcinoma of the eyelid with sebaceous differentiation. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3353.
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© ARVO (1962-2015); The Authors (2016-present)
Basal cell carcinoma is the most frequent malignant tumor of the eyelids. Although it exhibits broad morphological diversity, histopathological diagnosis is straightforward and the treatment is successful in the vast majority of cases. However, some cases are more difficult to diagnose as they may show overlapping similarities to adnexal tumors. Moreover, they can also possess areas of different cellular lineages, such as sebaceous differentiation. In these cases, it is important to differentiate between BCC and sebaceous carcinoma because treatment management varies significantly.
Clinical information of all the cases seen between 2006-2015 of BCC with sebaceous differentiation from the Henry C. Witelson Ocular Pathology Laboratory, McGill University were obtained and included in the analysis. All slides were re-evaluated, and expression of the immunohistochemical markers adipophilin, EMA, BRST2 and BER-Ep4 were evaluated. The clinical diagnosis, surgical report and follow-up information were analyzed for each case.
Nine cases of BCC with sebaceous differentiation were retrieved. The mean age of the patients was 75.9 ± 13.6 years, with a male predominance (n=7). The most common location was the lower eyelid (n=8). The average lesion size was 6.4 ± 3.4 mm. All areas with sebaceous differentiation were positive for adipophilin, while EMA was positive in 6/9 of these areas. Conversely, BCC areas without sebaceous differentiation were negative for these markers. None of the cases reviewed had recurrences or metastases.
BCC with sebaceous differentiation should be recognized as a tumor that often behaves like a typical BCC. While sebaceous carcinoma is more common on the upper eyelid, BCC with sebaceous differentiation was predominantly on the lower eyelid. EMA and adipophilin are strong immunohistochemical markers for the diagnosis of the sebaceous differentiated areas.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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