İntrakranial Uzanım Gösteren Perioküler Sebase Karsinom: Olgu Sunumu

Abstract

Sebase karsinom, genellikle göz kapaklarının meibomian bezlerinden kaynaklanan, yaygın ve invazif büyüme eğilimi gösteren nadir bir malign tümördür. Bu karsinomun intrakraniyal yayılımı olağanüstü derecede nadirdir ve literatürde yalnızca birkaç olgu bildirilmiştir. Bu olgu sunumunda kavernöz sinüs, Meckel cave ve temporal loba yayılan sebase karsinom olgusunu sunmaktayız. Hasta, cerrahi ve radyoterapi uygulanarak tedavi edilmiş; ancak, takip edilen görüntülemede önceki radyoterapiye sekonder bir menenjiyom tespit edilmiştir. Nüks veya metastatik hastalığın erken tespiti için düzenli izlem elzemdir. Bu raporda, karmaşık vakaların yönetiminde multidisipliner yaklaşım ile optimal hasta bakımının gerekliliği vurgulanmaktadır. Yakın takip ve kişiselleştirilmiş tedavi planlaması, bu tür vakalarda en iyi sonuçları sağlama açısından önem arz etmektedir.

Periocular sebaceous carcinoma with intracranial extension: A case report

Abstract

Sebaceous carcinoma, typically originating from the meibomian glands of the eyelids, is a rare malignant tumor with a propensity for diffuse, invasive growth. Intracranial extension of this carcinoma is exceptionally rare, with only a few cases reported. A 63-year-old male was referred to our tertiary hospital with swelling and pain in his right eye. The examination findings for the right eye revealed proptosis, chemosis, corneal opacity obstructing the visual axis, a membrane across the pupil, a shallow anterior chamber, and poor fundus visualization. On radiological imaging, a malignant mass with extension to the cavernous sinus and the temporal lobe was detected. The patient underwent surgery using supraorbital craniotomy, and the pathology came out to be sebaceous carcinoma. A partial excision was carried out with the preservation of the anatomical structures. There were no postoperative complications. The patient received adjuvant radiotherapy and is recurrence-free in a 3-year follow-up. However, a secondary meningioma associated with prior radiotherapy was identified on follow-up imaging. Unfortunately, the patient experienced notable right hemifacial muscle atrophy and severe fibrosis, causing eyelid adhesion following radiotherapy. We contend that an operative intervention prioritizing functional conservation, in conjunction with adjunct radiotherapy, would be deemed appropriate. Close follow-up and individualized treatment planning are essential for ensuring the best outcomes in this patient population.

Keywords

• sebaceous gland neoplasm
• intracranial neoplasms
• craniotomy
• case report

References

1. Slutsky JB, Jones EC. Periocular cutaneous malignancies: a review of the literature. Dermatol Surg. 2012;38(4):552-569. doi:10.1111/j.1524-4725.2012.02367.x
2. Colak A, Akkurt C, Ozcan OE, Onol B. Intracranial extension of meibomian gland carcinoma. J Clin Neuroophthalmol. 1991;11(1):39-42.
3. Shields JA, Demirci H, Marr BP, Eagle RC, Shields CL. Sebaceous carcinoma of the ocular region: a review. Surv Ophthalmol. 2005;50(2):103-122. doi:10.1016/j.survophthal.2004.12.008
4. Hayashi Y, Shima H, Kita D, et al. Intracranial extension of meibomian gland carcinoma with pagetoid changes. J Clin Neurosci. 2009;16(4):568-570. doi:10.1016/j.jocn.2008.04.030