Sebaceous glands are appendages in epidermis. Tumors of the sebaceous glands may be benign, such as sebaceous hyperplasia or sebaceous gland adenomas. The malignant sebaceous gland carcinoma generally arises from the glands within the eyelids, caruncle or eyebrow. They are more commonly occurred on the upper eyelid and in middle-aged patients. Meibomian gland carcinoma is the most common type. Sebaceous cell carcinoma is a lethal eyelid malignancy with metastasis (spreading of the disease to other parts of the body) but misinterpreted as benign conditions therefore error or delay in diagnosis is common thus tumor carries a significant mortality rate, 22%. The sebaceous cell carcinoma occurs 3.2% among malignant tumors and 0.8% of all eyelid tumors.
Sebaceous cell carcinomas are typically found in women, more often in old people, and they usually occur on the upper eyelid margin. It tends to invade locally, as well as spreading to regional lymph nodes.
Symptoms – There is an insidious onset of a painless firm eyelid mass. Tumors at the upper eyelid have a yellowish appearance. Classically, lesion is a firm, painless, indurate mass or ulceration associated with the loss of cilia, in an area that has been treated for recurrent stye. Sebaceous carcinomas are rare eye cancers and appear like a stye. But any eye tumor with persistent conjunctivitis, blepharo-conjunctivitis or chronic/recurrent stye and is not getting better after 3 months of observation must be suspected as sebaceous carcinoma and biopsied
Sebaceous cell carcinoma tends to invade locally, as well as spreading to regional lymph nodes.
Treatments – When the diagnosis is confirmed through biopsy, a survey for metastasis is done. Sebaceous carcinoma can spread to regional lymph nodes (pre-auricular and cervical) as well as to lungs, brain, liver and bone. The occurrence of metastatic disease is dependent on the size and location of the primary tumor and occurred in up to 27% of patients. Local tumor invasion of the lymph nodes, orbit or metastatic sites were associated with a poor prognosis for survival.
Surgical – COMPLETE resection is suggested. Procedure of permanent section control or Frozen section control is applied to provide negative margins. Larger surgeries, cryo-destruction and radiation may be required if resection is not possible. Exenteration (complete removal of the orbital contents) is sometimes required for extensive or recurrent disease.
Surgical – COMPLETE resection is suggested. Procedure of permanent section control or Frozen section control is applied to provide negative margins. Larger surgeries, cryo-destruction and radiation may be required if resection is not possible. Exenteration (complete removal of the orbital contents) is sometimes required for extensive or recurrent disease.
Medical Treatment – Carcinoma tumors are generally removed with the help of surgery. More serious carcinoma tumors require advanced medical treatment like Chemotherapy and Radiation. Sebaceous Gland Carcinoma tumors cause death of many patients due to spreading of the disease to other parts of the body (metastasis). Hence it is important to treat Sebaceous Gland cancer at the earliest.
Homoeopathic treatment – Though there are many homoeopathic medicines for tumors and glands, there is no specific medicine for sebaceous carcinoma of eyelid, mentioned in homoeopathic literature. Homoeopaths treat all types of disease with medicines selected on homoeopathic principles from that angle any of the homoeopathic medicine may be indicated covering the totality of symptoms.
The commonly used antitumor medicines are – Abrotanum, arsenicum alb., baryta carb., bromium, calcarea carb., calcarea flour., carbo animalis, conium, formic acid, hecla lava, lapis albus, lycopodium, nitric acid, phosphorus, phytolacca, scirrhinum, silicea, thuja etc.
Case – Smt. R. D. 55 yrs. Female Married Hindu Vegetarian
C T Scan (14/08/2010) – Small 17x11x11 cm size tissue density lesion seen along supra- lateral quadrant of right orbit – involving right eyelid. No underlying bone erosion. Lesion abutting (touching) the eye ball.
Biopsy (15/11/2010) – Sebaceous carcinoma of right upper eyelid.
Patient reported on 09/05/11 with a bluish red hard swelling with multiple nodules on upper eye lid. Some sites were softened to bleed freely after punch biopsy. Bleeding from two ulcerated sites of biopsy aggravated after walking or exertion. Stitching and pulsating pain and lachrymation aggravated from sun and after exertion. Pain on right side of the head during talking. The swelling was noticed in July – August 2010. It increased gradually but aggravated after November 2010. The patient observed that the swelling has increased after biopsy.
She had excessive thirst. Craving for cold, aversion to milk. Burning esophagus from spices. Perspire on face while walking.
Obese. Hight 5’3”. Weight 78 kg. Blood pressure 180/120 mm of hg.
Right upper Eyelid – A bluish red hard mass with multiple nodules covering whole eyelid. Some sites are softened and bleeding freely. No peri-auricular and cervical lymph node palpable.
09/05/11 Rx 1. Pulsatilla 30 two pills thrice daily.
2. Phosphorus 200 two doses at 10 minutes interval weekly
3. Rauwolfia Q 15 drops in ½ cup of water twice a day.
25/05/11 No change in bleeding and pain. there was burning along right eye brow extending to whole growth. Perspiration face increased. Blood pressure 150/110.
Rx 1. Pulsatilla 30 two pills thrice daily for one month.
2. Sulphur 30 two doses at 10 minutes interval weekly
3. Silicea 6x four tablets thrice a day for one month.
4. Hekla lava 4x thrice a day for one month.
5. Ointment Calendula to apply on the wound.
25/06/11 Discharge decreased but burning in inner canthus.
Rx 1. Zincum met 30 two pills thrice daily for one month.
2. Sulphur 200 two doses at 10 minutes interval weekly
3. Silicea 30 two pills thrice a day for one month.
4. Hekla lava 4x thrice a day for one month.
5. Ointment Calendula to apply on the wound.
13/07/11 As there was no change the patient reported before time.
Rx 1. Silicea 1M two doses at 10 minutes interval
2. Thuja 200 two doses at 10 minutes interval on 8th day after silicea.
3. Calcarea carb. 200 two pills once a day for 15 days.
4. Calendula 30 two pills thrice a day for 15 days.
5. Ointment Calendula.
29/07/11 All the previous prescriptions failed to bring any satisfactory result.
Rx 1. Conium 30 two pills thrice a day for 30 days.
2. Silicea 6x four tablets thrice a day for 30 days.
3. Ointment Calendula
05/09/11 Had viral fever about ten days back, took allopathic medicines. Now, weakness and sometimes vertigo are felt.
Tumor size decreased. Discharge and pain decreased. (May be due to antibiotics?). Picture taken.
Weight – 75 kg.
Rx 1. Conium 30 two pills thrice a day for 30 days.
2. Silicea 6x four tablets thrice a day for 30 days.
3. Ointment Calendula
Photo on 05/09/11
15/10/11 The right upper eye lid tumor size decreased more than 80% (See photo taken on 15/10/11). Now patient could open eye and had clear vision.
Since after viral fever she has right sided head pain off and on, vertigo while walking with sensation of falling forward. Not recovered from weakness.
Appetite, thirst, bowel and sleep normal. B. P. 140/100 mmHg.
Rx 1. Conium 30 two doses at 10 minutes interval every week.
2. Silicea 6x four tablets thrice a day for 30 days.
3. S. L. 30 two pills thrice a day.
4. Rauwolfia Q 10 drops once a day.
Photo on date 15/10/11
28/11/11 Vision was though clear and could open the eye but following symptoms persisted. The eyelid itch and burn after rubbing and from heat of stove. Redness of the eye and lachrymation from air draft, light and rubbing. Agglutination in morning with yellow discharge.
Vertigo on walking. Blood Pressure 130/100 mm Hg.
Rx 1. Conium 1M two doses at 10 minutes interval.
2. Silicea 6x four tablets thrice a day for 30 days.
3. S. L. 30 two pills thrice a day.
4. Rauwolfia Q 15 drops twice a day.
Dr. M. K. Tyagi
D.H.M.S., Dip. N.I.H., Research Officer
D.H.M.S., Dip. N.I.H., Research Officer
Mobile" 09829157926
Email: manju_mkt2003@yahoo.co.in
Sewa Mandir
Email: sewamandir@usa.net
Sewa Mandir
Email: sewamandir@usa.net
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