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Proceeding Volume 2 Issue 2
Outcomes for extra-ocular/orbital sebaceous carcinoma of the head & neck
Majid Al Thobaiti,
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Marc Camilon, Gabriel Calzada, Peter Martin, Michael McNicoll, Young Oh, Mark Segal, Terry Y Shibuya
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Department of Head, Neck Surgery Southern California Permanente Medical Group, USA
Correspondence: Magid Althbety, Department of Head, Neck Surgery, Southern California Permanente Medical Group, USA, Tel 00966554999047
Received: October 31, 2015 | Published: June 6, 2015
Citation: Thobaiti MAl, Camilon M, Calzada G, et al. Outcomes for extra-ocular/orbital sebaceous carcinoma of the head & neck. Endocrinol Metab Int J. 2015;2(2):70-72. DOI: 10.15406/emij.2015.02.00015
Back ground
Sebaceous glands are holocrine adnexal components of the skin that are usually found in close association with hair follicles. Historically, malignancies of the ocular adnexa were felt to be more aggressive than extra-ocular lesions, having greater potential for local invasion and metastatic spread. Recent literature suggests that the prognosis for extra-ocular sebaceous carcinoma SC is similar to that of oculo-cutaneous lesions.
Methods
We present 7 cases of extra-ocular malignancies arising from sebaceous glands in the head and neck. The cases of extra-orbital sebaceous cell malignancies in the world literature are also reviewed; their salient clinical, histology, and pathologic features are described (Figure 1-4).
Figure 1 SC of cheek at time of resection after lymphoscintographic injection.
Figure 2 SC on the forehead.
Figure 3 SC on the nasal dorsum.
Figure 4 SC on the tip of the nose.
Results
- Between 2008 and 2011, all cases of extra-ocular SC of the head & neck were identified. Retrospective chart review (Table 1) was performed and: age, sex, stage, location, SLNB, disease status, survival, correlation of disease status and SNLB.
- 7 Cases were identified where average age was 75 years old (65-85 years); with 4 Males and 3 Females.
- Classification includes 6 Stage I cancer and 1 Stage IV cancer.
- Extra-ocular SC locations: 2 cheek, 2 nose, 1 forehead, 1 neck, and 1 scalp (Table 2).
- Sentinal lymph node mapping was performed in 5 cases and biopsy was performed in 4 cases (Table 3).
- All patients are alive and disease free.
- A negative sentinal lymph node mapping or biopsy correlated with no evidence of metastatic disease in all cases.
|
Patient # |
Age |
Sex |
Stage |
Location |
Sentinal lymph node mapping |
Biopsy or neck dissection |
Procedure |
Radiation |
Disease status |
Survival (Months) |
|
1 |
85 |
F |
1 |
Forehead |
Yes |
No |
Wide excision of scalp CA, sentinal lymph node mapping |
No |
NED |
18 |
|
2 |
69 |
M |
1 |
Cheek |
Yes |
Yes |
Right cheek CA resect and right neck sentinal node biopsy x 2 |
No |
NED |
18 |
|
3 |
65 |
M |
1 |
Nose |
Yes |
No |
Wide resection of nasal CA, sentinal node mapping |
No |
NED |
30 |
|
4 |
75 |
F |
1 |
Nose |
Yes |
Yes |
Wide excision of nasal CA, sentinal lymph node bx |
No |
NED |
42 |
|
5 |
79 |
M |
1 |
Ear |
Yes |
No |
Wide excision of left posterior ear skin CA and alloderm graft |
No |
NED |
36 |
|
6 |
82 |
F |
4 |
Cheek |
No |
Yes |
Left cheekCA wide resect, left parotid, left ND zone 1-5 |
Yes |
NED |
19 |
|
7 |
68 |
M |
1 |
Neck |
No |
Yes |
Wide resection right neck CA and right neck dissection zone 2-5 |
No |
NED |
9 |
Table 1 Retrospective chart review
|
Average age |
74.7 Years |
|
Sex |
|
|
Male |
4 |
|
Female |
3 |
|
Stage |
|
|
1 |
6 |
|
2 |
0 |
|
3 |
0 |
|
4 |
1 |
|
Location |
|
|
Cheek |
2 |
|
Nose |
2 |
|
Ear |
1 |
|
Neck |
1 |
|
Forehead |
1 |
Table 2 Extra-ocular SC locations at different stages.
|
Sentinal lymph node mapping |
Neck disease status |
Post op radiation |
Disease status |
||||
|
Yes |
5 |
Pathologically positive |
1 |
Yes |
1 |
NED |
7 |
|
No |
2 |
Pathologically negative |
6 |
No |
6 |
Average survival |
24.6 months |
Table 3 Sentinal lymph node mapping.
Conclusion
Extra-ocular sebaceous cell carcinoma is a very rare maligancy. Our hospital based series is one of the largest reported to date. Aggressive surgical management is recommended and the use of SLNB can help predict whether metastatic disease is present.
Acknowledgments
None.
Conflict of interest
The author declares there is no conflict of interest.
©2015 Thobaiti, et al. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.