Title Intracranial extension of meibomian gland carcinoma with pagetoidchanges

This 41-year-old man presented with exophthalmos and loss in visual acuity. Neuroradiological study showed a large mass from the intraorbital region to the frontal lobe; it also involved the middle cranialand infratemporal fossa, and was accompanied by skull destruction. The tumor was almost totally removed. The histological diagnosis was sebaceous carcinoma with pagetoid changes. Despite surgery and local irradiation, intracranial metastases were recognized one year later and he underwent total removal and whole-brain irradiation. Although multiple lung metastases were detected one year after the 2 operation, 3 years after the surgery, he is free of intracranial recurrence. Sebaceous carcinomas of meibomian gland origin with pagetoid changes are a distinct, highly aggressive clinical entity. Early diagnosis and appropriate treatment are essential to improve the prognosis of patients with meibomian gland carcinoma with intracranial extension.