To the Editor.
—Drs Doxanas and Green1 have written an informative, useful article on sebaceous gland carcinoma. However, one statement concerning treatment is open to question: "If the pagetoid involvement is quite diffuse, one may elect to excise the carcinoma using frozen-section control, and leave the conjunctiva and lid margins intact if the patient can be followed-up closely."We do not believe there is any evidence to suggest that this is a safe form of treatment. On the contrary, every piece of evidence suggests the opposite. There is no question that sebaceous gland carcinoma is an aggressive, potentially lethal tumor. Knowingly leaving tumor cells in the eyelid must be viewed as dangerous. We do not know the biologic potential of these "pagetoid" or intraepithelial carcinoma cells. The authors pointed out that in some series, pagetoid involvement has been associated with increased mortality.2 It appears that early diagnosis and
Boynton JR, Searl SS. Sebaceous Gland Carcinoma. Arch Ophthalmol. 1985;103(2):175–179. doi:10.1001/archopht.1985.01050020027007
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