Date of Award

2024

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Kauffman, Russell

Keywords

sebaceous carcinoma, Mayo MTS score, extraocular sebaceous carcinoma, MMS, WLE, ocular sebaceous carcinoma, Muir-Torre Syndrome, immunohistochemistry, microsatellite instability, adjuvant therapy, incidence, and risk factors

Abstract

Sebaceous carcinomas (SC) have their origin in the sebaceous glands of the dermis and may develop as a result of de novo mutations, from benign sebaceous neoplasms, or as a result of microsatellite instability and loss of mismatch repair gene expression secondary to Muir-Torre Syndrome (MTS). SCs may also arise from the Meibomian glands, the glands of Zeis, or the sebaceous glands of the caruncle if occurring periocularly. Although SCs may occur at any sebaceous gland-containing location, the most common areas of involvement include the periocular, head, and neck regions. Given its capacity for nodal and distal metastasis as well as its association with significant morbidity and mortality, surgical excision must be pursued. The high recurrence rate and tendency of misdiagnosis that are associated with SCs, warrant swift diagnostic measures and the establishment of a gold-standard method of surgical treatment. Therefore, the purpose of this literature review is to compare the efficacies of MMS and WLE in the prevention of recurrence and metastasis of both extraocular and ocular SCs. Research articles were included if they analyzed either procedure individually or if they directly compared the two surgical modalities. No specific requirements were set, however patient inclusion criteria were evaluated in each article and included if similar themes were present. The current data available provides insufficient evidence for the recommendation of a single superior surgical modality. At this time, both modalities can be considered similarly efficacious.

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