S3431 An Odd Place for Acne: Ectopic Esophageal Sebaceous Glands

Abstract

INTRODUCTION: Sebaceous glands are typically found on the skin, providing lubrication to the skin and hair follicles. These glands are generally clustered on the face and scalp with fewer being found on the remaining skin surface. Esophageal sebaceous glands are extremely rare. As of 2017, less than 25 case reports had been published on this entity. Although rare and therefore not fully understood, esophageal sebaceous glands have not been linked to any attributable symptoms or risk or cancer. The following is a case of a patient evaluated for chronic cough who was ultimately found to have sebaceous glands in his esophagus. CASE DESCRIPTION/METHODS: A 63-year-old man was seen in gastroenterology clinic for evaluation of chronic cough and globus sensation. An esophagogastroduodenoscopy (EGD) displayed yellow, plaque-like material extending from proximal to distal esophagus (images A and B). These lesions could not be removed with lavage and were subsequently biopsied. The biopsy demonstrated a collection of round cohesive cells with cleared out cytoplasm and small centrally located nuclei arranged in an acinar configuration, consistent with ectopic sebaceous glands (image C). These glands are located within the lamina propria underlying a normal appearing stratified squamous cell epithelium. The patient also had esophageal pH testing showing a normal DeMeester score. Patient was treated with nasal fluticasone with improvement in his presenting symptoms. Therefore, symptoms were attributed to post-nasal drip, rather than the ectopic sebaceous glands. DISCUSSION: Ectopic esophageal sebaceous glands are a rare, benign finding. There is no known malignant potential to these lesions and no known attributable symptoms. Although rare and benign, endoscopists should have a familiarity with the appearance of ectopic esophageal sebaceous glands in order to distinguish them from other, non-benign lesions (such as squamous cell carcinoma) and potentially avoid unnecessary biopsies or other invasive testing.Figure 1.: Esophagus with sebaceous glands.Figure 2.: Esophagus with sebaceous glands.Figure 3.: Pathology slide of sebaceous glands in the esophagus.