Histopathologic Features That May Be Indicators of Prognosis in Ocular Sebaceous Carcinoma
Jyoti P Kapil, Vivian Yin, Denisa Kacerovska, Dmitry Kazakov, David Stockman, Bita Esmaeli, Doina Ivan. MD Anderson Cancer Center, Houston, TX; Charles University, Pilsen, Czech Republic
Background: Ocular sebaceous carcinomas are rare, representing approximately 5% of all malignant eyelid tumors. They are locally aggressive with regional and distant metastasis reported in 25% of cases. Our study sought to identify the histologic features associated with worse prognosis (local recurrence, regional lymph node and distant metastasis).
Design: Forty biopsy cases of sebaceous ocular carcinomas were obtained from the surgical files of a large tertiary care center in the United States and a European university hospital center over an 11-year period (1999-2010). Slides were obtained and histologic parameters including size, depth of invasion, level of invasion, mitotic count, ulceration, perineural and lymphovascular invasion were assessed. Clinical data was also reviewed when available.
Results: Patients showed a female predominance (F:M=3:1) with a mean age of 66.8 yrs (range:37-89). Sites of involvement included the eyelid (40/40, 100%) and additionally the conjunctiva (20/40, 50%). Mean measurement of tumor size was 7.8 mm (range:0.8-40). Tumor size (p<0.02) and tumor depth of invasion (p<0.002) significantly correlated with sentinel lymph node (SLN) positivity. Lymphovascular invasion was associated with distant (p<0.03) and SLN metastasis (p<0.004). Tumor necrosis was strongly associated with disease status. Sebaceous differentiation and mitotic activity were not significant histologic markers of prognosis. Pagetoid upward migration, lymphovascular and perineural invasion were not significantly associated with local recurrence.
Conclusions: We present one of the largest case series of ocular sebaceous cell carcinomas with an assessment of histologic parameters for their prognostic significance. Tumor size, depth of invasion, presence of lymphovascular invasion and tumor necrosis all correlated with regional lymph node and distant metastasis. Identification of these histologic features in small biopsy specimens may indicate a higher probability for metastasis and warrant closer clinical follow-up.
Tuesday, March 5, 2013 9:30 AM
Poster Session III # 216, Tuesday Morning