Sebaceous carcinoma of the eyelid can be associated with an aggressive course and poor prognosis. Identification of certain risk factors can help identify patients who might benefit from more aggressive therapy.
Indicators of a poor prognosis:
(1) involvement of the upper lid, especially with simultaneous involvement of both the upper and lower lid
(2) duration of symptoms for > 6 months
(3) infiltrative growth pattern
(4) moderate or poor sebaceous differentiation (little sebaceous differentiation)
(5) multi-centric origin
(6) intraepithelial carcinoma (Pagetoid spread)
(7) invasion of vascular and lymphatic channels
(8) invasion of the orbit
(9) size > 10 mm
|
Parameter |
Finding |
Mortality |
|
eyelid involvement |
lower eyelid |
0% |
|
|
upper eyelid |
27% |
|
|
both upper and eyelid |
83% |
|
duration of symptoms |
< 6 months |
14% |
|
|
>= 6 months |
38% |
|
infiltrative pattern |
minimal |
10% |
|
|
moderate |
27% |
|
|
high |
40% |
|
differentiation |
well-differentiated |
7% |
|
|
moderately differentiated |
29% |
|
|
poorly differentiated |
60% |
|
intraepithelial spread |
absent |
11% |
|
|
present |
41% |
|
invasion |
none |
16% |
|
|
orbital |
70% |
|
|
lymphatic |
83% |
|
|
vascular |
100% |
|
size |
< 6 mm |
0% |
|
|
6 to 10 mm |
18% |
|
|
11 to 20 mm |
50% |
|
|
> 20 mm |
60% |
The risk factors have not been subjected to multivariate analysis.
Specialty: Hematology Oncology, Surgery, general, Dermatology
