Sebaceous carcinoma of eyelid ? Understanding its unique cytomorphology and role of aspiration cytology

Introduction: Sebaceous carcinoma is a very rare malignant tumor primarily found in the area of the eyelid. We have reported here a case of sebaceous carcinoma of the eyelid with neck node metastasis diagnosed on fine needle aspiration cytology with emphasis on the unique cytomorphology of this tumor. Case history: A 35 year old woman presented with complaints of swelling in left upper eyelid, proptosis, loss of vision and cervical node enlargement. Fine needle aspiration (FNA) from the mass showed scattered and loose clusters of pleomorphic cells with increased nucleocytoplasmic ratio, prominent nucleoli, and abundant dense as well as vacuolated cytoplasm in a lipid backgound. A diagnosis of sebaceous carcinoma with cervical metastasis was made and confirmed on histopathology. Conclusion: FNA is a simple, cost effective technique for diagnosis of eyelid tumors. Familiarity with the cytomorphological features of sebaceous carcinoma can lead to early diagnosis of this malignancy with minimum discomfort to the patient.