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A. N. Odashiro, P. R. P. Odashiro, R. P. Gasparini, P. I. Fernandes, B. F. Fernandes, S. Di Cesare, S. C. Maloney, E. Antecka, C. Martins, M. N. Burnier, Jr.; Characterization of an Immunohistochemical Panel for Diagnosis of Sebaceous Carcinoma of the Eyelid. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3520.
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Sebaceous carcinoma (SC) is a tumor of the skin adnexae, more commonly located in the eyelid, and its diagnosis can be a challenge for the clinician and the ocular pathologist. Histopathologically, SC can mimic squamous cell carcinoma (SqCC) and basal cell carcinoma (BCC). Immunohistochemistry (IM) is a useful tool that could help ocular pathologists to make diagnosis of SC. Literature regarding IM and SC is scarce. The aim of this study is characterize a panel of IM antibodies for histopathological diagnosis of SC of the eyelid.
30 cases of eyelid tumors (10 SC, 10 BCC and 10 SqCC) were retrieved from the archives of the Ocular Pathology Department. A panel of IM antibodies was performed in all cases, including BRST-1, EMA, CAM 5.2, Ki67. A statistical analysis was performed.
All cases of SC were poorly differentiated, except two. 7 cases (70%) had features of SqCC and 3 (30%) of BCC. BRST-1 was positive in 100% of normal sebaceous glands and eccrine glands, when present. BRST-1 was diffusely positive in just 3 (30%) SC but was positive in all areas of sebaceous differentiation in 100% of the SC. BRST-1 was negative in all BCC and SqCC. EMA was positive in 100% of normal sebaceous glands and eccrine glands. EMA was diffusely positive in 60% of the SC (most with SqCC features) and in 90% of sebaceous differentiated areas of SC. It was positive in 70% of SqCC and negative in all cases of BCC. CAM5.2 was diffusely positive in 50% of SC and in 70% of sebaceous differentiated areas of SC. It was positive in 50% of BCC and 10% of SqCC. The proliferative index (ki67) had no differences between the tumors.
BRST-1, EMA and CAM5.2 can be used as IM panel to make the correct diagnosis of SC. BRST-1 is the single most important antibody. BRST-1 plus EMA and BRST-1 plus CAM5.2 can help distinguish SC from BCC and SqCC, respectively. All 3 antibodies stain sebaceous areas and the location of staining of each antibody should be interpreted carefully.
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