June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Sebaceous cell carcinoma presenting as an ocular Marjolin ulcer following exposure to a common alkaline cleaning agent
Author Affiliations & Notes
  • Brendon William Hung Chow Lee
    Ophthalmology, University of New South Wales, Sydney, New South Wales, Australia
  • Simon F Taylor
    Ophthalmology, The University of Sydney School of Medicine, Sydney, New South Wales, Australia
  • Andrew Gal
    Pathology, Histopath Diagnostic Services, Sydney, New South Wales, Australia
  • Dedee Murrell
    Dermatology, University of New South Wales, Sydney, New South Wales, Australia
  • Minas Coroneo
    Ophthalmology, University of New South Wales, Sydney, New South Wales, Australia
  • Footnotes
    Commercial Relationships   Brendon Lee None; Simon Taylor None; Andrew Gal None; Dedee Murrell None; Minas Coroneo None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 3149 – A0044. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Brendon William Hung Chow Lee, Simon F Taylor, Andrew Gal, Dedee Murrell, Minas Coroneo; Sebaceous cell carcinoma presenting as an ocular Marjolin ulcer following exposure to a common alkaline cleaning agent. Invest. Ophthalmol. Vis. Sci. 2022;63(7):3149 – A0044.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose : Marjolin ulcer is a rare and aggressive malignancy that originates from chronically inflamed, ulcerated, or scarred tissue. The potential for malignant transformation of ocular surface chemical injuries to a Marjolin ulcer is not well recognised. In fact, this progression may be accelerated by the immunosuppressive treatments often utilised to control the post-burn cicatrising process.

Methods : A 67-year-old, healthy and non-smoking, Caucasian lady presented with a 2 year history of pain, redness, tearing, and blurred vision in her right eye. She had suffered an alkaline burn of the right eye 4 years ago from a household cleaning agent. Right visual acuity was 6/400. Examination showed marked ocular surface disease and cicatrising conjunctivitis. Initial conjunctival biopsies returned negative for malignancy. Topical and systemic immunosuppression was underwent symblephara excision and amniotic transplantation. She eventually developed microbial keratitis and underwent an evisceration due to corneal perforation. Histopathological analysis showed high grade, poorly differentiated invasive sebaceous cell carcinoma with pagetoid intraepithelial spread and staining for BerEP4 and CK7 (Figure 1). To achieve tumor extirpation, an anterior exenteration was performed. No evidence of recurrence or metastasis was seen for 36 months.

Results : This is the second case of a sebaceous cell carcinoma Marjolin ulcer in the literature. We believe the theory most pertaining to an ocular Marjolin ulcer revolves around a co-carcinogen concept where the initial burn or injury acts to increase tissue susceptibility to other carcinogens such as ultraviolet radiation.

Conclusions : The potential for malignant transformation of ocular and pericoular chemical injuries into Marjolin ulcers needs to be recognised. Sebaceous cell carcinomas should be included in the potential spectrum of histopathology subtypes. We recommend that patients with previous chemical ocular burns, especially those initiated on immunosuppressive therapy, should be carefully evaluated, monitored, and counselled for the potential risk of Marjolin ulcer development.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

 

(A-B) (H&E) Multiple foci of high grade, poorly differentiated sebaceous cell carcinoma displaying pagetoid intraepithelial spread.
(C-D) (H&E) Intradermal clump of invasive sebaceous carcinoma, exhibiting central comedo type necrosis.

(A-B) (H&E) Multiple foci of high grade, poorly differentiated sebaceous cell carcinoma displaying pagetoid intraepithelial spread.
(C-D) (H&E) Intradermal clump of invasive sebaceous carcinoma, exhibiting central comedo type necrosis.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×