An advanced Sebaceous Gland Carcinoma of the eyelid: A rare case report

Sebaceous gland carcinoma (SGC) of the eyelid is an extremely lethal tumor if left untreated due to its extensive capacity to infiltrate surrounding tissue and metastasize. We hereby report a case of a 60-year-old male who presented with an ulcerative lesion over the left eye involving both eyelids and complete loss of vision for 1 year. CECT head and neck are suggestive of heterogeneously enhancing soft tissue density lesion with areas of necrosis within it seen in the left periorbital region. The lesion is causing erosive destruction of the lateral wall of the left orbit and involving the extra and intraconal compartment with ipsilateral enlarged parotid and cervical lymph nodes. Eyelid biopsy confirmed diagnosis of sebaceous carcinoma. The case was discussed in the Tumor board, and was advised upfront surgery. The patient underwent left extended orbital exenteration with left total parotidectomy, ipsilateral modified radical neck dissection and free anterolateral thigh flap reconstruction. Post-operative histopathology suggests SGC with parotid nodes and level IB, IIA lymph nodes positive for metastasis. Postoperatively patient underwent adjuvant radiotherapy. The patient is currently under regular follow-up and is disease free.