Korean J Ophthalmol.  2009 Jun;23(2):104-107. 10.3341/kjo.2009.23.2.104.

Primary Sebaceous Carcinoma of the Corneaoscleral Limbus With Pagetoid Recurrence

• Park SJ
• Wee WR
• Lee JH
• Kim MK

• KMID: 754726
• DOI: http://doi.org/10.3341/kjo.2009.23.2.104

Abstract

We report a sebaceous carcinoma confined to the corneoscleral limbus without involvement of the eyelid. A 60-year-old man, who showed multiple masses on the corneaoscleral limbus and limbal ulceration but with normal eyelids, underwent surgical en-bloc excision of the masses. Histopathologic examination revealed a sebaceous carcinoma. Three weeks after excision, multiple pagetoid recurrences were found along the bulbar conjunctiva 2 mm away from the limbus. After the application of topical mitomycin C, the pagetoid spread regressed completely. After a 2 year follow-up, no other local or systemic recurrences were observed. This report shows that the ulcerative mass which is confined to only the corneoscleral limbus may be a sebaceous carcinoma even without eyelid involvement. Topical mitomycin C may be effective for treating pagetoid spread of sebaceous carcinoma of limbal origin.

Keyword

Sebaceous carcinoma; Limbus; Conjunctiva; Pagetoid recurrence; Mitomycin C

MeSH Terms

Adenocarcinoma, Sebaceous/*pathology/surgery
Biological Dressings
Diagnosis, Differential
Eye Neoplasms/*pathology/surgery
Follow-Up Studies
Humans
Limbus Corneae/*pathology
Male
Middle Aged
*Neoplasm Recurrence, Local
Ophthalmologic Surgical Procedures/methods
Sebaceous Gland Neoplasms/*pathology/surgery

Figure

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  Fig. 1 Slit-lamp examination showed diffuse conjunctival injection and multiple nodular masses confined to inferior limbus and inferior bulbar conjunctiva along the limbus. The masses showed salmon-colored pebbly appearance accompanying peripheral corneal ulceration.

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  Fig. 2 Light microscopic view of the tumor. (A) At low magnification, the tumor is composed of relatively well-delineated lobules of sebaceous cells (×40). (B) At medium magnification, the tumor cell nest shows comedo-type necrosis (×100). (C) At higher magnification, the large cells with sebaceous differentiation, some of which are vacuolated, have small nuclei and clear cytoplasm (×200).

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  Fig. 3 Slit lamp examination revealed multiple pagetoid spread along with bulbar conjunctiva 2 mm away from the limbus (arrows).

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  Fig. 4 This photo shows clear conjunctiva and cornea after sebaceous carcinoma regressed completely.

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