Introduction

Sebaceous carcinoma is an uncommon malignant tumor which is derived from sebaceous glands. It is extremely rare in eye lids and when occurs it arises from accessory lacrimal glands or meibomian glands (1).

Sebaceous carcinomas can occur in two locations ocular and extraocular, ocular sebaceous carcinomas are more aggressive than extra ocular (2).

Epidermodysplasia verruciformis is a rare skin disease which is caused by human papilloma virus (3).

Epidermodysplasia verruciformis is a flat wart which is caused by viral changes in superficial keratinocytes and subsequent changes in keratin production (4).we reported this case since the ocular type is rare and had not been reported previously. Although it had showed invasion and multiple recurrences during this 3 years, it did not cause blindness.

Case report

A 50 year old male patient attended to Besat hospital of Hamedan university of Medical Science Hamedan, Iran. Complaining of itching and bleeding skin lesion on the inner canthus of the eyes (Fig.1).

The patient was a taxi driver, so he was exposed to considerable amount of sunlight and he also had a usual habit of touching and cleaning the corner of the eye by his fingers.

Patient had brown flat pigmentations all over his body which were more pronounced on sun exposed areas and a bit depigmented on the hands and face because of frequent washing and rubbing.

His father, his son and also his cousin have the same skin pigmentations. He was diagnosed for epidermodysplasia verruciformis when he was 20 year-old. He mentioned that he was suffering from the same mentioned warts on the Inner cantus of the left eye for several years and recently he felt that it had become itchy and started bleeding upon itching since last month (Fig.1A and B).

Prior to surgical treatment an incisional biopsy obtained in infirmary and histopathologic diagnosis of squamous cell carcinoma considered.

One week later the patient attended for surgical treatment considering Moh’s micrographic surgery.

On frozen sections, diagnosis of sebaceous carcinoma had been proposed which had been confirmed later on permanent processing of obtained tissues (Fig.2).

There have been no bone invasion of lateral nasal and also no global invasion.

To further confirm the histopathologic diagnosis, Immunohistochemical examination with Epithelial membrane antigen(EMA), Carcinoembryonic antigen (CEA), CK7 and Androgen receptor obtained in which EMA, CK7, Androgen receptor were positive and CEA have been negative (Fig.3).

Fig 1. A and B patient 3 years ago. C: patient last month

Fig 2. Hematoxylin and Eosin sections. A: x10.  B: x40.  C and D: x100

Fig 3. Immunohistochemical analysis shows,
 A: CEA negativity.
 B: EMA strong positivity C: CK7 weakly positive.

D: shows strong positivity of tumor cells with androgen receptor