[Therapy refractory blepharoconjunctivitis in a 90 year old patient].

Area of Science:

• Ophthalmology
• Oncology
• Dermatology

Background:

• Sebaceous gland carcinoma (SGC) is a rare malignancy of the eyelid.
• It can present with symptoms mimicking benign ocular conditions like chalazion and blepharitis.
• Early and accurate diagnosis is essential for effective treatment and prognosis.

Observation:

• Unilateral, recalcitrant chalazion and unilateral, therapy-refractory blepharitis warrant exclusion of SGC.
• Autosomal dominant Muir-Torre syndrome (MTS) is associated with an increased risk of SGC.
• MTS involves SGC of the ocular adnexa combined with visceral malignancies.

Findings:

• Clinical presentation of SGC can be misleading, resembling benign eyelid pathologies.
• Histopathological evaluation is the gold standard for diagnosing SGC.
• Suspicion of SGC should be heightened in cases of unilateral, persistent, or treatment-resistant eyelid lesions.

Implications:

• Ophthalmologists and dermatologists must maintain a high index of suspicion for SGC.
• Prompt histological assessment can prevent delayed diagnosis and treatment of SGC.
• Genetic counseling and screening for visceral malignancies are recommended for patients with SGC, particularly those with suspected MTS.