Аденокарцинома сальной железы века

Abstract

Sebaceous carcinoma belongs to rare malignant tumors of the eyelids, is characterized by a variety of clinical manifestations and is often disguised as other tumors or inflammatory diseases of the eyelids. The purpose of the work is to analyze the clinical picture and features of the course of sebaceous carcinoma. Material and methods. From January 2015 to December 2020, 6 patients were diagnosed with cancer of the sebaceous gland (5 patients with adenocarcinoma of the meibomian glands, 1 with adenocarcinoma of the Zeiss sebaceous glands). 4 were women and 2 were men aged from 59 to 89 years. Results. From the moment the first symptoms appeared to adequate treatment, 6-12 months passed. According to the 8th revision of the T-classification of malignant tumors of the AJCC eyelids, two patients had T2b, three had T3b, and one patient had T3c stage. A painless thickening of the eyelid cartilage and the eyelid margin was accompanied by the growth of yellowish dense masses on the conjunctiva in two women; the tumor spread to the eyelid skin in one patient. By the time the primary tumor was diagnosed, none of the patients had metastases to regional lymph nodes and hematogenous metastases. Wide excision of the tumor with simultaneous plastic surgery of the eyelid was performed in 4 patients. After excisional biopsy, 3 patients underwent local external beam radiation therapy to the area of the affected eyelid (Total dose 60 Gy.). Orbital exenteration was performed in two patients. The observation period for the patients: 3 months – 49 months. One patient died of a cause unrelated to the tumor. One patient died of metastases of Zeiss glands adenocarcinoma. Relapse of the tumor developed and metastasis to the preauricular lymph node appeared in one patient. Conclusion. Diagnosis of the sebaceous gland cancer of the eyelids is difficult, it is detected late. Ki67 does not depend on the size of the tumor, however, the large size of the tumor is an unfavorable factor in the prognosis of the disease. All patients with cancer of the sebaceous gland after treatment need to be followed up for at least 5 years with whole body PET/CT once a year. Key words: sebaceous carcinoma of the eyelids, adenocarcinoma of the meibomian glands, adenocarcinoma of the Zeiss sebaceous glands.