Eyelid sebaceous carcinoma associated with Muir-Torre syndrome in two cases

We report the rare but serious association between sebaceous carcinoma of eyelid and Muir-Torre syndrome in two cases, a 79-year-old woman and 54-year-old man. The presenting sign was a yellow-pink nodule with telangiectatic vessels on the left lower eyelid in one patient and a yellowish-red, pedunculated lesion with intrinsic vascularization on the right superior tarsal conjunctiva in the other. A history of multiple primary colon cancers was present in both patients, associated transitional cell carcinoma of bladder and renal cancer in one patient and prostate cancer in the other. Both patients underwent excisional biopsy and cryotherapy of the eyelid tumors. Histopathology revealed sebaceous carcinoma of eyelid and conjunctiva. Immunohistochemical staining for MSH2 DNA mismatch repair gene performed in one patient showed lack of expression. Muir-Torre syndrome was diagnosed on the basis of sebaceous carcinoma, associated with multiple visceral malignancies in both patients. We conclude that patients with sebaceous carcinoma should have evaluation for visceral malignancies, mainly colon cancer.