Diagnosis of a sebaceous gland carcinoma

The diagnosis is often made by a combination of a clinical picture and a tissue sample (biopsy). Conspicuous skin changes or eyelid swelling in the eye are examined by light microscopy (histological). If the suspicion of sebaceous gland carcinoma of the eye (ocular) or the rest of the body (extraocular) is confirmed in the tissue sample, computer tomography is usually performed to assess the entire body or the eye socket as well as the adjacent structures. Thus, on the one hand, the spread of the tumor and on the other hand, any existing metastases can be assessed.

By these symptoms one can recognize a sebaceous gland carcinoma

A sebaceous gland carcinoma cannot be treated conservatively or with medication alone. Due to the aggressiveness of the tumor, the therapy of choice is therefore the generous surgical removal. If lymph nodes are affected, they are also removed and the remaining tissue is irradiated.

In the case of advanced (ocular) sebaceous gland carcinoma of the eye, if the orbit is also affected, the entire orbit is removed. In this case, a glass eye can be inserted at a later stage if the patient wishes. The surgical removal of the tumor is usually followed by radiation therapy. Since the tumor tends to grow back at the removed site, regular clinical check-ups are necessary in order to be able to act early in case of doubt.

Prognosis for sebaceous gland carcinoma

In up to 40% of cases, the tumor recurs at the removed site within the first years after surgery. With ocular localization (on the eye) the risk is lower with 20%. Sebaceous gland carcinoma is an extremely aggressive growing tumor, which can quickly form metastases (daughter tumors) with increasing size.

Therefore, the increasing tumor size is also a prognostically unfavorable parameter. Other unfavorable factors are the penetration of the tumor into vessels and the occurrence of the tumor at several locations in the body. Furthermore, a low differentiation of the cells in the tissue examination is to be considered unfavorable. Here, it is assessed how far the cells deviate from the cells of the original tissue.