Sebaceous carcinoma of the ocular adnexa: radiotherapeutic management

A total of 30 patients with histologically confirmed sebaceous carcinoma of the ocular adnexa were evaluated at our institution from 1974-1986. There were 18 women and 12 men in the series with a median age of 61 years. Ten cases received radiotherapy with curative intent. Four patients were treated definitively with doses ranging from 45-63.0 Gy over 4-7 weeks. Six patients received post-operative radiotherapy to the parotid bed and ipsilateral cervical lymph node chain for parotid metastases developing within 36 months of initial surgical treatment. Patients with lower lid lesions and significant pagetoid histologic components were more likely to develop parotid lymph node metastases. Local control at the primary site after radiation and/or surgery was 90% with follow-up ranging from 2-10 years. Overall disease specific actuarial survival at 5 years was 96%. Radiation therapy is an effective treatment modality in adnexal sebaceous carcinoma. With employment of careful technique and state-of-the-art technology, long term local control and survival with satisfactory cosmetic and functional results can be anticipated.