Surgical management of a case of a large recurrent sebaceous carcinoma of the lower eyelid
Journal Title: MedPulse -International Medical Journal - Year 2015, Vol 2, Issue 10
Abstract
Background: Sebaceous carcinoma is an eyelid malignancy commonly seen in Asian population that originates from the Meibomian glands, glands of Zeis or from the sebaceous glands in the caruncle. It is sometimes mistaken for a chalazion or a benign lid mass or a blepharoconjunctivitis and hence not managed well. Case: We present one such case, a 55-year-old woman who presented with a recurrent sebaceous carcinoma in the lower lid that progressed rapidly to attain a large size of 22mm X 18mm X15mm. The tumour was excised with wide margins of 6mm and under frozen section control. The lower lid was then reconstructed with the help of a large Hughes tarsoconjunctival flap from the upper lid for forming the posterior lamella and a cheek rotation flap for constructing the anterior lamella. After three weeks, the conjunctival pedicle was severed and the lids could be opened. Observations: The reconstructed lower lid was well apposed to the globe and was functionally and cosmetically satisfactory. The patient has been on a regular follow up for the past 15 months and has not had a local recurrence, regional lymph node involvement or a systemic metastasis as yet. Conclusions: Excision of an eyelid malignancy should be done with wide margins and under frozen section analysis and lid reconstruction should be done only when the margins are declared to be tumour free. Hughes tarsoconjunctival flap combined with a cheek rotation flap provide a good outcome in patients with large recurrent sebaceous carcinoma of the lower lid.
Authors and Affiliations
V Kohli, S T Mittal, S Kumar
Keywords
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