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Presumed Primary Papillary Sebaceous Carcinoma of the Palpebral Conjunctiva

Frederick A. Jakobiec, MD, DSc1; Anna M. Stagner, MD1; Michael A. Nowak, MD2; Peter A. D. Rubin, MD3
[+] Author Affiliations
1David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston
2Palm Beach Dermatology, Diagnostic Dermatopathology, West Palm Beach, Florida
3Ophthalmic Plastic Surgery, Palm Beach Gardens, Florida
JAMA Ophthalmol. 2015;133(5):612-614. doi:10.1001/jamaophthalmol.2014.5870.
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Sebaceous carcinoma can arise in the meibomian glands of the eyelids and in the sebaceous glands of the eyelashes.1 Origination from the conjunctival epithelium is controversial in contrast to the sebaceous glands.2 We describe a de novo palpebral sebaceous carcinoma that did not display involvement of the tarsal meibomian glands.

Article InformationCorresponding Author: Frederick A. Jakobiec, MD, DSc, David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts Eye and Ear Infirmary, 243 Charles St, Ste 328, Boston, MA 02114 (fred_jakobiec@meei.harvard.edu).

Published Online: February 5, 2015. doi:10.1001/jamaophthalmol.2014.5870.

Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

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Figure 1.
Conjunctival Sebaceous Carcinoma

A, Interpalpebral papillary lesion. B, Pedunculated base. C, Flattened surface (black arrowheads) and papillary fronds (blue arrowheads). ST indicates stroma (hematoxylin-eosin, original magnification ×10). D, Elongated fronds (arrowheads) (hematoxylin-eosin, original magnification ×12.5). E, Microinvasive tumor (T) into stroma (ST) and up to tarsus (arrowhead) (hematoxylin-eosin, original magnification ×50). F, Short extension of carcinoma in situ (arrowhead). TA indicates tarsus (hematoxylin-eosin, original magnification ×100).

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Figure 2.
Pathologic and Immunohistochemical Features

A, Vacuolated cells (hematoxylin-eosin, original magnification ×400). B, Vacuolated (V) and nonvacuolated (NV) undifferentiated tumor cells abut (hematoxylin-eosin, original magnification ×200). Inset, Multinucleated tumor giant cell (hematoxylin-eosin, original magnification ×400). C, Uninvolved inferior palpebral conjunctiva (arrowheads). MG indicates meibomian gland; TA, tarsus (hematoxylin-eosin, original magnification ×200). D, Vesicular adipophilin positivity (immunoperoxidase reaction, diaminobenzidine chromogen, hematoxylin counterstain, original magnification ×400). E, Androgen receptor nuclear positivity (immunoperoxidase reaction, diaminobenzidine chromogen, hematoxylin counterstain, original magnification ×200). F, High Ki-67 positivity (immunoperoxidase reaction, diaminobenzidine chromogen, hematoxylin counterstain, original magnification ×100).

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