Abstract
Purpose :
Sebaceous cell carcinoma (SC) is a malignant tumour that clinically overlaps with other eyelid lesions and tumors, such as chalazion, basal cell carcinoma (BCC), and squamous cell carcinoma (SCC). Any misdiagnosis may impact the course of treatment and outcome for patients. The purpose of this study is to perform a 12-year review evaluating the inconsistency in the clinical and histopathological diagnosis of SC.
Methods :
A retrospective analysis of 2497 tumours out of 6828 cases submitted to the MUHC-McGill University Ocular Pathology & Translational Research Laboratory from January 2006 to May 2018 was performed. Of these cases, 92 had either a clinical diagnosis or a clinical suspicion of SC. The discrepancies between the clinical and the histopathological diagnosis were further evaluated.
Results :
Of the 92 in which SC was in the differential diagnosis, 28 had a final diagnosis as SC. From these 28 tumors, 14 were diagnosed both clinically and pathologically as SC, while 14 did not have a final clinical diagnosis. Out of the 14 remaining tumors, 5 were clinically diagnosed as BCC, 2 as SCC, 2 as a chalazion, 1 as a pinguecula and 1 as a verruca. The 3 remaining tumors, had an uncertain clinical diagnosis, including BCC and SCC. From the 64 cases that were not pathologically diagnosed as SC, 27 were diagnosed as chalazion, 17 as BCC, 14 as chronic inflammations, 2 sebaceous adenomas, 4 had no specific clinical suspicion.
Conclusions :
Sebaceous carcinomas represent a challenge and may be misdiagnosed for benign and malignant lesions. In our study of 92 cases, 14 patients did not have the clinical diagnosis of SC which was only confirmed histopathologically. On the other hand, 64 patients had a clinical suspicion of SC which was not confirmed histopathologically. Basal cell carcinoma and chalazion are the most frequent mimickers of SC. Due to the fact that the most important prognostic factor of SC is the time from the clinical diagnosis to treatment, it is crucial to perform an early an accurate diagnosis.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.