Please use this identifier to cite or link to this item: https://hdl.handle.net/2440/129624
Type: Thesis
Title: Sebaceous Carcinoma
Author: Wu, Albert
Issue Date: 2020
School/Discipline: Adelaide Medical School
Abstract: Sebaceous carcinoma (SC) is a rare skin cancer which usually occurs on the head and neck, and has a propensity for metastasis. It is easily mistaken for benign conditions, resulting in inappropriate management. Thus, it is important to maintain a high index of suspicion for SC, to avoid delay in diagnosis and worsening of prognosis. Due to its poor prognosis and tendency to occur on cosmetically sensitive areas, the primary treatment of SC should be margin control surgery, preferably Mohs micrographic surgery. Chapter 1 is a comprehensive review on cutaneous SC, discussing its epidemiology, clinical features, histologic features, pathogenesis and management. There has been significant uncertainty about the demographics and anatomical distribution of SC. Of particular note, it has frequently been assumed that SC occur more commonly in Asians than whites; however, data to support this are limited. Chapter 2 investigates these uncertainties by comparing the previously published incidence rates of SC in various countries. However, the incidence rates could not be compared accurately as different studies focused on different anatomical sites, and adjusted to different standard populations. To facilitate a more accurate comparison of incidence rates and further clarify the uncertainties about the epidemiology of SC, Chapter 3 presents new data obtained from cancer registries of the United States, England, Norway and Taiwan, and calculates incidence rates with uniform age-adjustment. Chapter 4 reports a case of eyelid SC in situ that presented atypically as a haemorrhagic cyst. Chapter 5 describes an unusual case of SC with lacrimal sac involvement, presenting with clinical features of nasolacrimal duct obstruction. The optimal management of SC remains uncertain, due to its rarity and thus limited data on which to base recommendations. Areas of uncertainty include whether to investigate for subclinical metastasis and other malignancies of Muir-Torre Syndrome, whether to perform sentinel lymph node biopsy and conjunctival map biopsies, and whether to use intraoperative histologic margin control and if so which method (e.g. frozen section, paraffin section, or Mohs). In Chapter 6, the management preferences of different groups of clinicians in different countries are surveyed (Australian Mohs surgeons, and Australian, New Zealand, and Japanese oculoplastic surgeons). This may provide a foundation to develop Asia-Pacific consensus guidelines.
Advisor: Selva, Dinish
Huilgol, Shyamala
Rajak, Saul
Dissertation Note: Thesis (MPhil) -- University of Adelaide, Adelaide Medical School, 2020
Keywords: Skin cancer
basal cell carcinoma
squamous cell carcinoma
Provenance: This electronic version is made publicly available by the University of Adelaide in accordance with its open access policy for student theses. Copyright in this thesis remains with the author. This thesis may incorporate third party material which has been used by the author pursuant to Fair Dealing exceptions. If you are the owner of any included third party copyright material you wish to be removed from this electronic version, please complete the take down form located at: http://www.adelaide.edu.au/legals
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