ISSN: 2473-0815 EMIJ

Endocrinology & Metabolism International Journal
Proceedings
Volume 2 Issue 2 - 2015
Outcomes for Extra-Ocular/Orbital Sebaceous Carcinoma of the Head & Neck
Majid Al-Thobaiti*, Marc Camilon, Gabriel Calzada , Peter Martin, Michael McNicoll, Young Oh, Mark Segal and Terry Y. Shibuya
Department of Head & Neck Surgery, Southern California Permanente Medical Group, USA
Received: October 31, 2014 | Published: June 06, 2015
*Corresponding author: Magid Althbety, Department of Head & Neck Surgery, Southern California Permanente Medical Group, USA, Tel: 00966554999047; Email: @
Citation: Thobaiti MAl, Camilon M, Calzada G, Martin P, McNicoll M, et al. (2015) Outcomes for Extra-Ocular/Orbital Sebaceous Carcinoma of the Head & Neck. Endocrinol Metab Int J 2(2): 00015. 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

GH: Growth Hormone; TSH: 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

  1. 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.
  2. 7 Cases were identified where average age was 75 years old (65-85 years); with 4 Males and 3 Females.
  3. Classification includes 6 Stage I cancer and 1 Stage IV cancer.
  4. Extra-ocular SC locations: 2 cheek, 2 nose, 1 forehead, 1 neck, and 1 scalp (Table 2).
  5. Sentinal lymph node mapping was performed in 5 cases and biopsy was performed in 4 cases (Table 3).
  6. All patients are alive and disease free.
  7. 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.
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