Mitomycin-C as adjuvant therapy in the treatment of sebaceous gland carcinoma in high-risk locations

Purpose: To report on the use of Mitomycin-C as adjuvant therapy to excision and cryotherapy in patients with sebaceous gland carcinoma (SGC) in high-risk locations. Design: Retrospective, consecutive, case series. Participants: Three patients with SGC of the upper palpebral conjunctiva or caruncle, but without clinical pagetoid spread. Methods: Following excision and double freeze-thaw cryotherapy, patients with histology demonstrating SGC of the ocular surface were treated with topical Mitomycin-C (0.04%). Follow-up was conducted over an average of 30 months (range: 24–37 months). Main outcome measures: Postoperative evidence of local recurrence, lymph node or distant organ metastasis. Results: No patients had evidence of local recurrence or systemic disease. Conclusions: Wide surgical excision with cryotherapy is the basis of treatment of SGC without pagetoid spread. The use of Mitomycin-C as adjuvant therapy remains controversial, although there is some rationale for its use in high-risk situations.Adam K Rudkin and James S Mueck