Sebaceous carcinoma of the eyelid metastasizing to the lacrimal sac after 5 years.

Eyelid sebaceous carcinoma metastasizing to lacrimal sac is rare. A 65 year old female underwent excision with 5 mm margins and Cutler-beard reconstruction for a nodulo-ulcerative mass showing eyelash loss in the middle third of the right upper eyelid. Histopathology confirmed it to be sebaceous carcinoma with uninvolved margins. Five years after primary excision, the patient presented with persistent epiphora and mass in the ipsilateral lacrimal sac region. Repeat excision biopsy and conjunctival map biopsy confirmed recurrent sebaceous carcinoma of the lacrimal sac. Thirteen months after adjuvant radiotherapy to the orbit, the patient is alive and well with no loco-regional recurrence.