Case Letter
Extraocular sebaceous carcinoma: tumor presentation of rapid evolution
Luana Moraes Campos, Joana Alexandria Ferreira Dias, Paula Basso Lima, Sílvio Alencar Marques
Autor para correspondência
Faculdade de Medicina, Universidade Estadual Paulista, Botucatu, SP, Brazil
Lido
5677
Vezesque se leu este artigo
2368
Total PDF
3309
Total HTML
Compartilhar estatÃsticas
array:24 [ "pii" => "S0365059621003202" "issn" => "03650596" "doi" => "10.1016/j.abd.2020.09.017" "estado" => "S300" "fechaPublicacion" => "2022-03-01" "aid" => "511" "copyright" => "Sociedade Brasileira de Dermatologia" "copyrightAnyo" => "2022" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by/4.0/" "subdocumento" => "sco" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "pt" => array:19 [ "pii" => "S2666275222000121" "issn" => "26662752" "doi" => "10.1016/j.abdp.2022.01.012" "estado" => "S300" "fechaPublicacion" => "2022-03-01" "aid" => "511" "copyright" => "Sociedade Brasileira de Dermatologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by/4.0/" "subdocumento" => "sco" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "pt" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta ‐ Caso clínico</span>" "titulo" => "Carcinoma sebáceo extraocular: apresentação tumoral de rápida evolução" "tienePdf" => "pt" "tieneTextoCompleto" => "pt" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "268" "paginaFinal" => "271" ] ] "contieneTextoCompleto" => array:1 [ "pt" => true ] "contienePdf" => array:1 [ "pt" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1336 "Ancho" => 1006 "Tamanyo" => 211922 ] ] "descripcion" => array:1 [ "pt" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Carcinoma sebáceo extraocular. Tumoração de 5<span class="elsevierStyleHsp" style=""></span>cm, bocelada, eritemato‐vinhosa, de localização pré‐auricular direita, com áreas friáveis e necróticas. Lesão satélite de 1<span class="elsevierStyleHsp" style=""></span>cm com características semelhantes e cicatriz de exérese de carcinoma espinocelular.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Luana Moraes Campos, Joana Alexandria Ferreira Dias, Paula Basso Lima, Sílvio Alencar Marques" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Luana Moraes" "apellidos" => "Campos" ] 1 => array:2 [ "nombre" => "Joana Alexandria Ferreira" "apellidos" => "Dias" ] 2 => array:2 [ "nombre" => "Paula Basso" "apellidos" => "Lima" ] 3 => array:2 [ "nombre" => "Sílvio Alencar" "apellidos" => "Marques" ] ] ] ] ] "idiomaDefecto" => "pt" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0365059621003202" "doi" => "10.1016/j.abd.2020.09.017" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059621003202?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275222000121?idApp=UINPBA00008Z" "url" => "/26662752/0000009700000002/v1_202204130559/S2666275222000121/v1_202204130559/pt/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S0365059621003160" "issn" => "03650596" "doi" => "10.1016/j.abd.2021.07.006" "estado" => "S300" "fechaPublicacion" => "2022-03-01" "aid" => "507" "copyright" => "Sociedade Brasileira de Dermatologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by/4.0/" "subdocumento" => "sco" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case Letter</span>" "titulo" => "Is there a link between guttate psoriasis and SARS-CoV-2? A series of three cases" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "271" "paginaFinal" => "273" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1129 "Ancho" => 2507 "Tamanyo" => 257464 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Guttate psoriasis and chronic plaque psoriasis flare (case 1): (A) Guttate psoriasis drop-like erythematous plaques and scaly erythematous plaques on the trunk; (B) Guttate psoriasis drop-like erythematous plaques on the upper limbs; (C) Scaly erythematous plaques on the elbows.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Cláudia Brazão, Miguel Alpalhão, Marta Aguado-Lobo, Joana Antunes, Luís Soares-de-Almeida, Paulo Filipe" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Cláudia" "apellidos" => "Brazão" ] 1 => array:2 [ "nombre" => "Miguel" "apellidos" => "Alpalhão" ] 2 => array:2 [ "nombre" => "Marta" "apellidos" => "Aguado-Lobo" ] 3 => array:2 [ "nombre" => "Joana" "apellidos" => "Antunes" ] 4 => array:2 [ "nombre" => "Luís" "apellidos" => "Soares-de-Almeida" ] 5 => array:2 [ "nombre" => "Paulo" "apellidos" => "Filipe" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S266627522200008X" "doi" => "10.1016/j.abdp.2022.01.008" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S266627522200008X?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059621003160?idApp=UINPBA00008Z" "url" => "/03650596/0000009700000002/v2_202204021027/S0365059621003160/v2_202204021027/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0365059621002981" "issn" => "03650596" "doi" => "10.1016/j.abd.2020.10.018" "estado" => "S300" "fechaPublicacion" => "2022-03-01" "aid" => "489" "copyright" => "Sociedade Brasileira de Dermatologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by/4.0/" "subdocumento" => "sco" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case Letter</span>" "titulo" => "Bullous Sweet syndrome with a unique photodistributed pattern" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "266" "paginaFinal" => "268" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1090 "Ancho" => 1156 "Tamanyo" => 260012 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">(A), Histological features showing dense neutrophilic infiltration throughout the edematous dermis (Hematoxylin & eosin, original magnification ×40). (B), Higher magnification showing the large number of infiltrating neutrophils (Hematoxylin & eosin, ×400). (C), Histological examination showing a septal panniculitis in the subcutaneous nodule in the lower extremity (Hematoxylin & eosin, ×20).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Mai Endo, Miyuki Yamamoto, Mikio Ohtsuka, Toshiyuki Yamamoto" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Mai" "apellidos" => "Endo" ] 1 => array:2 [ "nombre" => "Miyuki" "apellidos" => "Yamamoto" ] 2 => array:2 [ "nombre" => "Mikio" "apellidos" => "Ohtsuka" ] 3 => array:2 [ "nombre" => "Toshiyuki" "apellidos" => "Yamamoto" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S2666275221003040" "doi" => "10.1016/j.abdp.2021.12.004" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275221003040?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059621002981?idApp=UINPBA00008Z" "url" => "/03650596/0000009700000002/v2_202204021027/S0365059621002981/v2_202204021027/en/main.assets" ] "en" => array:17 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case Letter</span>" "titulo" => "Extraocular sebaceous carcinoma: tumor presentation of rapid evolution" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "268" "paginaFinal" => "271" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Luana Moraes Campos, Joana Alexandria Ferreira Dias, Paula Basso Lima, Sílvio Alencar Marques" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Luana Moraes" "apellidos" => "Campos" ] 1 => array:2 [ "nombre" => "Joana Alexandria Ferreira" "apellidos" => "Dias" ] 2 => array:2 [ "nombre" => "Paula Basso" "apellidos" => "Lima" ] 3 => array:4 [ "nombre" => "Sílvio Alencar" "apellidos" => "Marques" "email" => array:1 [ 0 => "silvio.marques@unesp.br" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Faculdade de Medicina, Universidade Estadual Paulista, Botucatu, SP, Brazil" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1336 "Ancho" => 994 "Tamanyo" => 207909 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Extraocular sebaceous carcinoma. Tumor measuring 5 cm, rounded, with an erythematous-violaceous color, located on the right preauricular region, with friable and necrotic areas. Satellite lesion measuring 1 cm with similar features besides a SCC excision scar.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Sebaceous carcinoma (SC) is a rare malignant neoplasm derived from the adnexal epithelium of the sebaceous glands, with a higher incidence in the ocular region, particularly in the eyelid region, and has a potentially aggressive behavior.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–3</span></a> Older age, previous radiotherapy, and association with Muir-Torre syndrome are predisposing conditions.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">This is the case report of a 75-year-old white male patient with a history of squamous cell carcinoma (SCC), referred for treatment of facial lesion noted three months before, with rapid growth and bleeding episodes associated with trauma. Upon examination, a 5-cm, rounded, erythematous-violaceous, pre-auricular tumor was observed, with friable and necrotic areas associated with a 1-cm satellite lesion with similar characteristics and a post-SCC excision skin graft scar (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). No regional lymph node enlargement was detected. The hypotheses were SCC, SCC metastasis, and angiosarcoma. Histopathological examination (<a class="elsevierStyleCrossRefs" href="#fig0010">Figs. 2 and 3</a>) showed a dermal neoplasm with polygonal clear cells, evident nuclear pleomorphism, cell debris, and frequent mitoses. Immunohistochemistry disclosed positivity for epithelial markers AE1/AE3 and epithelial membrane antigen (EMA) which, associated with histopathological findings, allowed the diagnosis of sebaceous carcinoma (SC), and thus, the patient was referred to the Head and Neck Surgery Division of the institution.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">In a review of 1349 SC cases, a predominance of males (54%) was observed, as well as mean age of 73 years, 86% whites, 38.7% on the palpebra, with a survival rate of 91.9%, and 79.2% in 5 and 10 years respectively.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The most frequent metastases were found in the lymph nodes.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,3</span></a> Most cases occur <span class="elsevierStyleItalic">de novo</span>, although it may originate from benign sebaceous lesions and, when located in the upper or lower eyelid, it is associated with the Meibomian and Zeis glands.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–3</span></a> Clinical presentation is variable; it is usually painless and slow-growing, but it can be rapid-growing and aggressive.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">It is the third or fourth most frequent malignant neoplasm of the eyelids, depending on the reference.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–3</span></a> The most frequent extraocular location is the cephalic segment, especially the face. The diagnosis of SC should be a warning sign, as it is a possible marker of Muir-Torre syndrome, a genodermatosis characterized by the presence of skin tumors of sebaceous origin associated with systemic malignancies, particularly of the gastrointestinal tract.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> A subcutaneous nodule is usually observed in SC, which is normochromic; however, it may disclose different morphologies, colors and behavior, depending on its place of origin.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–3</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The differential diagnosis of extraocular SC includes basal cell carcinoma (BCC), SCC, amelanotic melanoma, Merkel cell carcinoma, and cutaneous lymphoma.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,3</span></a> The immunohistochemical use of markers for BerEP4, EMA (negative in BCC), AE1 and AE3 (negative in melanoma, lymphomas), adipophilin (negative in SCC, Merkel), p53 and Ki-67, will aid in the diagnosis and prognosis.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–4</span></a> The treatment comprises surgical resection with a 1-cm margin or the use of the micrographic surgical technique.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> A therapeutic option in cases of metastatic SC to the lungs and CNS is immunotherapy with pembrolizumab, which belongs to the class of inhibitors of anti-PD1 immunological checkpoints (programmed death-1), and is also used in metastatic melanoma and Merkel cell carcinoma.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">This case report exemplifies a case of an atypical presentation of extraocular SC, especially due to the rapid growth and aggressiveness of the tumor, which when diagnosed had a specific satellite lesion and tumorous clinical aspect.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financial support</span><p id="par0035" class="elsevierStylePara elsevierViewall">None declared.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Authors’ contributions</span><p id="par0040" class="elsevierStylePara elsevierViewall">Luana Moraes Campos: Approval of the final version of the manuscript; design and planning of the study; critical review of the literature.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Joana Alexandria Ferreira Dias: Approval of the final version of the manuscript; critical review of the manuscript.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Paula Basso Lima: Approval of the final version of the manuscript; collection, analysis, and interpretation of data; critical review of the manuscript.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Sílvio Alencar Marques: Approval of the final version of the manuscript; drafting and editing of the manuscript; critical review of the literature; critical review of the manuscript.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of interest</span><p id="par0060" class="elsevierStylePara elsevierViewall">None declared.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Financial support" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Authors’ contributions" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Conflicts of interest" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2020-05-16" "fechaAceptado" => "2020-09-22" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Study conducted at the Department of Infectology, Dermatology, Diagnostic Imaging and Radiotherapy, Faculdade de Medicina, Universidade Estadual Paulista, Campus de Botucatu, SP, Brazil.</p>" ] ] "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1336 "Ancho" => 994 "Tamanyo" => 207909 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Extraocular sebaceous carcinoma. Tumor measuring 5 cm, rounded, with an erythematous-violaceous color, located on the right preauricular region, with friable and necrotic areas. Satellite lesion measuring 1 cm with similar features besides a SCC excision scar.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1351 "Ancho" => 1801 "Tamanyo" => 468873 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Extraocular sebaceous carcinoma. Neoplasm characterized by polygonal clear cells, nuclear pleomorphism, cell debris, and frequent mitoses (Hematoxylin & eosin, ×40).</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1360 "Ancho" => 1811 "Tamanyo" => 342322 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Extraocular sebaceous carcinoma. Detail of neoplastic cells showing nuclear pleomorphism, prominent nucleoli, and multilobular cytoplasm (Hematoxylin & eosin, ×400).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A retrospective review of 1349 cases of sebaceous carcinoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "T. Dasgupta" 1 => "L.D. Wilson" 2 => "J.B. Yu" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Cancer" "fecha" => "2009" "volumen" => "115" "paginaInicial" => "158" "paginaFinal" => "165" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sebaceous carcinoma: evidence-based clinical practice guidelines" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.L. Owen" 1 => "N. Kibbi" 2 => "B. Worley" 3 => "R.C. Kelm" 4 => "J.V. Wang" 5 => "C.A. Barker" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Lancet Oncol" "fecha" => "2019" "volumen" => "20" "paginaInicial" => "699" "paginaFinal" => "714" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiology of sebaceous carcinoma of the head and neck: implications of the lymph node management" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G. Tryggvason" 1 => "R. Bayon" 2 => "N.A. Pagedar" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Head Neck" "fecha" => "2012" "volumen" => "34" "paginaInicial" => "1765" "paginaFinal" => "1768" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sebaceous carcinoma: clinicopathologic features and diagnostic role of immunohistochemistry (including androgen receptor)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "K. Mulay" 1 => "V.A. White" 2 => "S.J. Shah" 3 => "S.G. Honavar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jcjo.2014.04.004" "Revista" => array:6 [ "tituloSerie" => "Can J Ophthalmol" "fecha" => "2014" "volumen" => "49" "paginaInicial" => "326" "paginaFinal" => "332" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25103648" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Near complete response to Pembrolizumab in microsatellite-stable metastatic sebaceous carcinoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Domingo-Musibay" 1 => "P. Murugan" 2 => "A. Giubellino" 3 => "S. Sharma" 4 => "D. Steiberger" 5 => "J. Yuan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s40425-018-0357-3" "Revista" => array:5 [ "tituloSerie" => "J Immunother Cancer" "fecha" => "2018" "volumen" => "6" "paginaInicial" => "58" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29914578" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/03650596/0000009700000002/v2_202204021027/S0365059621003202/v2_202204021027/en/main.assets" "Apartado" => array:4 [ "identificador" => "82769" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case Letter" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/03650596/0000009700000002/v2_202204021027/S0365059621003202/v2_202204021027/en/main.pdf?idApp=UINPBA00008Z&text.app=https://clinics.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059621003202?idApp=UINPBA00008Z" ]
| Ano/Mês | Html | Total | |
|---|---|---|---|
| 2024 Novembro | 25 | 10 | 35 |
| 2024 Outubro | 156 | 69 | 225 |
| 2024 Setembro | 182 | 80 | 262 |
| 2024 Agosto | 206 | 119 | 325 |
| 2024 Julho | 189 | 114 | 303 |
| 2024 Junho | 156 | 72 | 228 |
| 2024 Maio | 96 | 73 | 169 |
| 2024 Abril | 115 | 90 | 205 |
| 2024 Março | 109 | 73 | 182 |
| 2024 Fevereiro | 130 | 85 | 215 |
| 2024 Janeiro | 90 | 62 | 152 |
| 2023 Dezembro | 72 | 61 | 133 |
| 2023 Novembro | 80 | 93 | 173 |
| 2023 Outubro | 90 | 80 | 170 |
| 2023 Setembro | 78 | 91 | 169 |
| 2023 Agosto | 62 | 44 | 106 |
| 2023 Julho | 71 | 58 | 129 |
| 2023 Junho | 56 | 42 | 98 |
| 2023 Maio | 73 | 24 | 97 |
| 2023 Abril | 56 | 26 | 82 |
| 2023 Março | 77 | 55 | 132 |
| 2023 Fevereiro | 48 | 31 | 79 |
| 2023 Janeiro | 62 | 55 | 117 |
| 2022 Dezembro | 53 | 34 | 87 |
| 2022 Novembro | 92 | 64 | 156 |
| 2022 Outubro | 117 | 67 | 184 |
| 2022 Setembro | 75 | 84 | 159 |
| 2022 Agosto | 64 | 47 | 111 |
| 2022 Julho | 80 | 68 | 148 |
| 2022 Junho | 134 | 99 | 233 |
| 2022 Maio | 89 | 67 | 156 |
| 2022 Abril | 96 | 114 | 210 |
| 2022 Março | 147 | 106 | 253 |
| 2022 Fevereiro | 33 | 44 | 77 |
| 2022 Janeiro | 50 | 67 | 117 |
Mostrar tudo
