Aggressive sebaceous carcinoma of the eyelid: an elusive diagnosis

Sebaceous carcinoma of the eyelid, an extremely rare neoplasm, can resemble blepharitis, conjunctivitis, or chalazion, as in the case presented here. A biopsy specimen should be examined if these conditions fail to respond to therapy, especially if the lesion is unilateral. The tumor can be multifocal, and pagetoid proliferation is common. Therefore, recurrences are common after conservative surgery, even if frozen sections are obtained from the margins. Orbital exenteration may be necessary to prevent metastasis.