Intraoperative Adjunctive Mitomycin C and Cryotherapy for Recurrent Conjunctival Papillary Sebaceous Carcinoma
| Autor: | Satoko Morohashi, Katsunori Yokoi, Mitsuru Nakazawa, Akira Kurose, Hideaki Hirai, Takayuki Gonome, Reiko Tanabu, Natsuki Monai, Satoshi Urushidate |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Meibomian gland Cryotherapy Case Report 030230 surgery 03 medical and health sciences 0302 clinical medicine lcsh:Ophthalmology Conjunctival sebaceous carcinoma Mitomycin C medicine Sebaceous carcinoma business.industry Papillary tumor medicine.disease Surgery Ophthalmology medicine.anatomical_structure lcsh:RE1-994 Pagetoid Adjunctive treatment 030221 ophthalmology & optometry Eyelid business |
| Zdroj: | Case Reports in Ophthalmology Case Reports in Ophthalmology, Vol 9, Iss 1, Pp 221-226 (2018) |
| ISSN: | 1663-2699 |
| Popis: | Purpose: To report a case of recurrent conjunctival papillary sebaceous carcinoma that was successfully treated by a combination of surgical resection, intraoperative topical mitomycin C application, and cryotherapy. Observations: A woman in her 80s developed a yellowish papillary tumor pedunculated from the surface of the upper palpebral tarsal conjunctiva in her left eye. She was histopathologically diagnosed as having sebaceous carcinoma by an excisional biopsy. We performed en bloc resection of the lateral one-third of the posterior lamella including the cutaneous margin of the upper eyelid as well as reconstruction of the defected portion by a switch-flap from the ipsilateral lower eyelid. Histopathologically, because the tumor was restricted to the epithelial region with minimal invasion into the tarsus, we diagnosed the patient to have conjunctival papillary sebaceous carcinoma. Nine months after the surgery, the tumor recurred and was resected and treated by intraoperative mitomycin C. Four months later, the tumor regrew at the resected margins and was treated by resection combined with mitomycin C and cryotherapy. After these combination treatments, the tumor did not recur for at least 1 year postoperatively. Conclusion and Importance: Although sebaceous carcinoma usually originates from the meibomian gland cells or less frequently from the Zeis or Moll gland cells, it rarely occurs from bulbar or palpebral conjunctival cells. Because sebaceous carcinoma sometimes shows a pagetoid growth pattern, it can recur even after en bloc resection with a negative study for tumor cells at the surgical margins. The recurrent sebaceous carcinoma cells showed an intraepithelial growth pattern. Considering this superficial growth property, it may be effective to apply intraoperative mitomycin C and cryotherapy treatment combined with surgical resection to reduce the possibility of recurrence of presumed conjunctival papillary sebaceous carcinoma, although mitomycin C alone seems to be insufficient as an adjunctive treatment. |
| Databáze: | OpenAIRE |
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