Congenital cystic eye in utero: novel prenatal magnetic resonance imaging findings.

the propensity for skip lesions (intraepithelial neoplasia) in sebaceous carcinoma, microscopic intraepithelial neoplasia may be present even with negative margins and may lead to local recurrences. It is interesting that our patient developed a late regional nodal metastasis without any evidence of local recurrence. One plausible explanation is that the primary sebaceous carcinoma in the caruncle was a very low-grade, slow-growing carcinoma that gained access to the lymphatic channels at the time of original diagnosis and before surgical removal of the ocular tumor and, because of its slow-growing nature, it took 11 years for the nodal metastasis to reach a size to be detectable on palpation by the patient. Typical follow-up for a patientwith periocular sebaceous carcinoma includes serial examination of the ocular surgical site, palpation of the regional lymph nodes, and imaging (eg, ultrasonography or computed tomography) of the regional lymph nodes for 5 years after resection of the primary tumor. Although it isunrealistic, on thebasis of this single case, to recommend surveillance of patients with periocular sebaceous carcinomabeyond5years, it is important for clinicians andpatients to be aware of the potential for late nodalmetastasis of sebaceous carcinoma beyond the initial 5 years after diagnosis and treatmentof theocular tumor. Patientswithocular and periocular sebaceous carcinoma should be educated regarding the possible but rare incidence of late relapse in the regional lymph nodes and the location of lymph nodes at risk in the parotid and submandibular regions.