Intraoperative Adjunctive Mitomycin C and Cryotherapy for Recurrent Conjunctival Papillary Sebaceous Carcinoma
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...
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doaj-c07bbbb2ad924ca18f07fa5b8fa124b42020-11-25T00:10:55ZengKarger PublishersCase Reports in Ophthalmology1663-26992018-03-019122122610.1159/000487704487704Intraoperative Adjunctive Mitomycin C and Cryotherapy for Recurrent Conjunctival Papillary Sebaceous CarcinomaNatsuki MonaiReiko TanabuTakayuki GonomeKatsunori YokoiSatoshi UrushidateSatoko MorohashiHideaki HiraiAkira KuroseMitsuru NakazawaPurpose: 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.https://www.karger.com/Article/FullText/487704Mitomycin CCryotherapyConjunctival sebaceous carcinomaSebaceous carcinoma |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Natsuki Monai Reiko Tanabu Takayuki Gonome Katsunori Yokoi Satoshi Urushidate Satoko Morohashi Hideaki Hirai Akira Kurose Mitsuru Nakazawa |
spellingShingle |
Natsuki Monai Reiko Tanabu Takayuki Gonome Katsunori Yokoi Satoshi Urushidate Satoko Morohashi Hideaki Hirai Akira Kurose Mitsuru Nakazawa Intraoperative Adjunctive Mitomycin C and Cryotherapy for Recurrent Conjunctival Papillary Sebaceous Carcinoma Case Reports in Ophthalmology Mitomycin C Cryotherapy Conjunctival sebaceous carcinoma Sebaceous carcinoma |
author_facet |
Natsuki Monai Reiko Tanabu Takayuki Gonome Katsunori Yokoi Satoshi Urushidate Satoko Morohashi Hideaki Hirai Akira Kurose Mitsuru Nakazawa |
author_sort |
Natsuki Monai |
title |
Intraoperative Adjunctive Mitomycin C and Cryotherapy for Recurrent Conjunctival Papillary Sebaceous Carcinoma |
title_short |
Intraoperative Adjunctive Mitomycin C and Cryotherapy for Recurrent Conjunctival Papillary Sebaceous Carcinoma |
title_full |
Intraoperative Adjunctive Mitomycin C and Cryotherapy for Recurrent Conjunctival Papillary Sebaceous Carcinoma |
title_fullStr |
Intraoperative Adjunctive Mitomycin C and Cryotherapy for Recurrent Conjunctival Papillary Sebaceous Carcinoma |
title_full_unstemmed |
Intraoperative Adjunctive Mitomycin C and Cryotherapy for Recurrent Conjunctival Papillary Sebaceous Carcinoma |
title_sort |
intraoperative adjunctive mitomycin c and cryotherapy for recurrent conjunctival papillary sebaceous carcinoma |
publisher |
Karger Publishers |
series |
Case Reports in Ophthalmology |
issn |
1663-2699 |
publishDate |
2018-03-01 |
description |
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. |
topic |
Mitomycin C Cryotherapy Conjunctival sebaceous carcinoma Sebaceous carcinoma |
url |
https://www.karger.com/Article/FullText/487704 |
work_keys_str_mv |
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