A 40-year-old woman was referred to our department for persistence for about eight months of a picture of anterior blepharitis of indolent appearance with the appearance of an indurated nodule in the right upper eyelid classified as "chalazion refractory to triamcinolone injection", associated with ipsilateral preauricular lymphadenopathy. A biopsy of the palpebral nodule was performed and reported after histopathological analysis as sebaceous carcinoma.

The right upper eyelid was then completely excised, including the tarsus, and reconstructed with a free graft of palatal mucosa and covered with a pedicled frontal glabellar flap. Border involvement was ruled out in the resected surgical specimen. At the same time, a radical cervical removal was performed due to the presence of necrotic lymphadenopathies in various lymphatic territories. In the same surgical procedure, the conjunctiva was biopsied in all four quadrants as well as the lower eyelid. The anatomopathological study showed no conjunctival infiltration, but tumoural changes in the lower eyelid, so brachytherapy was used for a total of 94 sessions with the isotope iridium 192 at a dose of 0.67 Gy for each session (total dose of 63.8 Gy). External radiotherapy was also associated with the cervical region in order to complete the surgical treatment carried out on the cervical region.