Management of recurrent sebaceous gland carcinoma



To evaluate the incidence and management of recurrent periocular sebaceous gland carcinoma at a tertiary ocular oncology service in the United Kingdom.


This was a retrospective cohort study of 62 patients with sebaceous gland carcinoma treated between 2004 and 2017. A total of 10 eyes were treated for local recurrence. The following variables were recorded: age and sex of patient; tumour location, histological subtype; recurrence type; treatment and outcome.


Of the 62 cases with eyelid SGC, 10 (16%) had recurrences during the study period and satisfied inclusion criteria. There were six (60%) females and four males in the recurrent group. The mean time interval between initial excision and tumour recurrence was 37 months (median 23 months; range 4 to 84 months). Four patients received cryotherapy to the lids and conjunctiva to control recurrent disease and two patients were treated with topical or intralesional chemotherapy. Four patients (40%) underwent orbital exenteration during the study period. Metastasis occurred in 20% over a mean follow-up of 113 months (median 106; range 47–184 months).


The risk factors for local recurrence of SGC after wide excision with paraffin section control were reported, and an approach to these recurrent lesions was proposed. The results of this study will help guide surgeons dealing with the medical and surgical conundrum of recurrent disease. The risk of recurrence is highest in the first 2 years after initial excision.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.

Fig. 1: Conjunctival map biopsy specimen locations.
Fig. 2
Fig. 3: Recurrent SGC.


  1. 1.

    Shields JA, Demirci H, Marr BP, Eagle RC, Shields CL. Sebaceous carcinoma of the eyelids: personal experience with 60 cases. Ophthalmology. 2004;111:2151–7.

    Article  PubMed  Google Scholar 

  2. 2.

    Putterman AM. Conjunctival map biopsy to determine pagetoid spread. Am J Ophthalmol. 1986;102:87–90.

    CAS  Article  Google Scholar 

  3. 3.

    Rao NA, Hidayat AA, McLean IW, et al. Sebaceous carcinomas of the ocular adnexa: a clinicopathologic study of 104 cases, with five-year follow-up data. Hum Pathol. 1982;13:113–22.

    CAS  Article  Google Scholar 

  4. 4.

    Song A, Carter KD, Syed NA. et al. Sebaceous cell carcinoma of the ocular adnexa: clinical presentations, histopathology, and outcomes. Ophthalmic Plast Reconstr Surg. 2008;24:194–200.

    Article  PubMed  Google Scholar 

  5. 5.

    Yoon JS, Kim SH, Lee CS, et al. Clinicopathological analysis of periocular sebaceous gland carcinoma. Ophthalmologica. 2007;221:331–9. 10.1159/000104764 [published Online First: 2007/08/31]

    Article  Google Scholar 

  6. 6.

    Zurcher M, Hintschich CR, Garner A, et al. Sebaceous carcinoma of the eyelid: a clinicopathological study. Br J Ophthalmol. 1998;82:1049–55.

    CAS  Article  Google Scholar 

  7. 7.

    Muqit MM, Roberts F, Lee WR. et al. Improved survival rates in sebaceous carcinoma of the eyelid. Eye. 2004;18:49–53.

    CAS  Article  PubMed  Google Scholar 

  8. 8.

    Sa HS, Tetzlaff MT, Esmaeli B. Predictors of local recurrence for eyelid sebaceous carcinoma: questionable value of routine conjunctival map biopsies for detection of pagetoid spread. Ophthalmic Plast Reconstr Surg. 2019.

  9. 9.

    Sa HS, Rubin ML, Xu S, et al. Prognostic factors for local recurrence, metastasis and survival for sebaceous carcinoma of the eyelid: observations in 100 patients. Br J Ophthalmol. 2018.

  10. 10.

    Chao AN, Shields CL, Krema H, et al. Outcome of patients with periocular sebaceous gland carcinoma with and without conjunctival intraepithelial invasion. Ophthalmology. 2001;108:1877–83.

    CAS  Article  Google Scholar 

  11. 11.

    Carcinoma Skin of the Eyelid. TNM classification of malignant tumours. 8th ed. Wiley-Blackwell; United Kingdom. 2016:136.

  12. 12.

    While B, Salvi S, Currie Z. et al. Excision and delayed reconstruction with paraffin section histopathological analysis for periocular sebaceous carcinoma. Ophthal Plast Reconstr Surg. 2014;30:105–9.

    Article  PubMed  Google Scholar 

  13. 13.

    Esmaeli B, Nasser QJ, Cruz H. et al. American Joint Committee on Cancer T category for eyelid sebaceous carcinoma correlates with nodal metastasis and survival. Ophthalmology. 2012;119:1078–82.

    Article  PubMed  Google Scholar 

  14. 14.

    Kass LG, Hornblass A. Sebaceous carcinoma of the ocular adnexa. Surv Ophthalmol. 1989;33:477–90.

    CAS  Article  Google Scholar 

  15. 15.

    Lam SC, Li EYM, Yuen HKL. 14-Year case series of eyelid sebaceous gland carcinoma in Chinese patients and review of management. Br J Ophthalmol. 2018.

  16. 16.

    Zhou C, Wu F, Chai P, et al. Mohs micrographic surgery for eyelid sebaceous carcinoma: A multicenter cohort of 360 patients. J Am Acad Dermatol. 2019.

  17. 17.

    Kaliki S, Ayyar A, Dave TV. et al. Sebaceous gland carcinoma of the eyelid: clinicopathological features and outcome in Asian Indians. Eye. 2015;29:958–63.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  18. 18.

    Takahashi Y, Takahashi E, Nakakura S. et al. risk factors for local recurrence or metastasis of eyelid sebaceous gland carcinoma after wide excision with paraffin section control. Am J Ophthalmol. 2016;171:67–74.

    Article  PubMed  Google Scholar 

  19. 19.

    Lee IJ, Koh JY Impact of clinicopathologic factors on survival in patients with sebaceous carcinoma of the eyelid—a population-based analysis. Orbit. 2018:1–8.

  20. 20.

    Shields JA, Saktanasate J, Lally SE. et al. Sebaceous carcinoma of the ocular region: The 2014 Professor Winifred Mao lecture. Asia Pac J Ophthalmol. 2015;4:221–7.

    Article  Google Scholar 

  21. 21.

    Jakobiec FA, Werdich X. Androgen receptor identification in the diagnosis of eyelid sebaceous carcinomas. Am J Ophthalmol. 2014;157:687–96 e1-2.

    CAS  Article  PubMed  Google Scholar 

  22. 22.

    Mulay K, White VA, Shah SJ, et al. Sebaceous carcinoma: clinicopathologic features and diagnostic role of immunohistochemistry (including androgen receptor). Can J Ophthalmol. 2014;49:326–32. [published Online First: 2014/08/12]

    Article  Google Scholar 

  23. 23.

    Plaza JA, Mackinnon A, Carrillo L, et al. Role of immunohistochemistry in the diagnosis of sebaceous carcinoma: a clinicopathologic and immunohistochemical study. Am J Dermatopathol. 2015;37:809–21. [published Online First: 2015/10/21]

    Article  Google Scholar 

  24. 24.

    Shields CL, Naseripour M, Shields JA, et al. Topical mitomycin-C for pagetoid invasion of the conjunctiva by eyelid sebaceous gland carcinoma. Ophthalmology. 2002;109:2129–33. [published Online First: 2002/11/05]

    Article  Google Scholar 

  25. 25.

    Rudkin AK, Muecke JS. Mitomycin-C as adjuvant therapy in the treatment of sebaceous gland carcinoma in high-risk locations. Clin Exp Ophthalmol. 2009;37:352–6. [published Online First: 2009/07/15]

    Article  Google Scholar 

  26. 26.

    Tumuluri K, Kourt G, Martin P. Mitomycin C in sebaceous gland carcinoma with pagetoid spread. Br J Ophthalmol. 2004;88:718–9.

    CAS  Article  Google Scholar 

  27. 27.

    Graefe T, Wollina U, Schulz H. et al. Muir-Torre syndrome—treatment with isotretinoin and interferon alpha-2a can prevent tumour development. Dermatology. 2000;200:331–3.

    CAS  Article  PubMed  Google Scholar 

  28. 28.

    Shields JA, Demirci H, Marr BP, et al. Sebaceous carcinoma of the ocular region: a review. Surv Ophthalmol. 2005;50:103–22.

    Article  Google Scholar 

  29. 29.

    Lisman RD, Jakobiec FA, Small P. Sebaceous carcinoma of the eyelids. The role of adjunctive cryotherapy in the management of conjunctival pagetoid spread. Ophthalmology. 1989;96:1021–6.

    CAS  Article  Google Scholar 

  30. 30.

    Hata M, Koike I, Omura M, et al. Noninvasive and curative radiation therapy for sebaceous carcinoma of the eyelid. Int J Radiat Oncol Biol Phys. 2012;82:605–11.

    Article  Google Scholar 

  31. 31.

    Kaliki S, Ayyar A, Nair AG. et al. Neoadjuvant systemic chemotherapy in the management of extensive eyelid sebaceous gland carcinoma: a study of 10 cases. Ophthal Plast Reconstr Surg. 2016;32:35–9.

    Article  PubMed  Google Scholar 

  32. 32.

    Lee SH, Jung YH, Yoo JY. et al. A case report of recurrent metastatic sebaceous carcinoma which showed favorable response Tt non-fluorouracil based chemotherapy. Am J Case Rep.2018;19:1192–6.

    Article  PubMed  PubMed Central  Google Scholar 

  33. 33.

    Cheung JJC, Esmaeli B, Lam SC, et al. The practice patterns in the management of sebaceous carcinoma of the eyelid in the Asia Pacific region. Eye. 2019.

  34. 34.

    Khan JA, Doane JF, Grove AS Jr. Sebaceous and meibomian carcinomas of the eyelid. Recognition, diagnosis, and management. Ophthal Plast Reconstr Surg. 1991;7:61–6.

    CAS  Article  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Lindsay A. McGrath.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

McGrath, L.A., Currie, Z.I., Mudhar, H.S. et al. Management of recurrent sebaceous gland carcinoma. Eye 34, 1685–1692 (2020).

Download citation


Quick links