Sebaceous carcinoma of the eyelids is a malignant tumor that originates in the meibomian gland. In Japan, the nodular type is most common, whereas the diffuse type, which diffusely extends to the eyelid, is rare. In our department, pathological examination of an extended tumor resection revealed a case of poorly differentiated sebaceous carcinoma with pagetoid spread (intraepithelial invasion of the tumor cells), which is commonly observed in the diffuse type, in addition to the nodular type. Preserving the eyeball was difficult because of extensive invasion of the sebaceous carcinoma to the eyelid conjunctiva and its adjacent eyeball; therefore, the orbital content was removed surgically. The postoperative margins were negative, and the patient had no recurrence. We report this case and have conducted a review of the literature because this is an unusual histopathological finding in a Japanese patient.
