Sebaceous Cell Carcinoma Research Articles

Recurrent Nasal Sebaceous Carcinoma in Human Immunodefiency Virus/ Hepatitis B Virus (HIV/HBV) Coinfection Patient: A Case Report

Background: Human Immunodefiency Virus (HIV) since the first case was reported is recognized as a major risk factor for development of different types of malignancies, Sebaceous carcinoma is a rare and aggressive form of cutaneous carcinoma and very rare in HIV Patients. Method: A case report and literature review of 46 years old male, known to have HIV/HBV coinfection presented with a history of four months of gradual growth Nasal mass. Result: Excisional biopsy performed for the nasal mass and histopathology examination showed sebaceous cell carcinoma, Surgical removal of the nasal mass was done and nasal reconstruction with right paramedian forehead flap plus full thickness skin graft taken from the abdomen for reconstruction of the inner nose also was done, after two years patient came back with recurrent at same site. Conclusion: sebaceous cell carcinoma is an extremely rare in HIV patients, but should be considers for any skin tumor in HIV patient, follow up also needed for the risk of recurrent.

Eyelid Tumors: Clinical Data from an Eye Center in Ankara, Turkey

The aim of the study was to explore the distribution of eyelid tumors in Ankara, the capital city of Turkey, from a histopathological point of view. Medical records of 1,502 patients who had eyelid surgery because of tumoral lesions were retrospectively reviewed after obtaining institutional review board approval. A total of 1,541 lesions with histopathologic diagnosis were included. Inflammatory tumoral lesions were excluded. The lesions were categorized into three groups according to the origin: epidermal, adnexal tumors and 'others', including melanocytic, neural and vascular lesions. Of the total of 1,541, 908 lesions were epidermal in origin. Only 22 (1.5%) were malignant, and 6.0% was premalignant lesions such as actinic keratosis and Bowen's disease. Twenty-one of 22 malignant lesions were basal cell carcinoma. There was only one patient with squamous cell carcinoma and no sebaceous cell carcinoma. Among the benign tumors (92.5%), squamous papilloma was the most frequent (21.8% of all lesions). The other frequent lesions were nevus (17.6%), seborrheic keratosis (17.3%), hydrocystomas (10.6%), xanthelasma (7.6%) and epidermal cysts (7.2%). The results of this study are in accordance with published literature. The absence of sebaceous cell carcinomas needs to be stressed.

Sebaceous Cell Carcinoma: Wide Histological Spectrum and Correlation to Prognosis. A Case Report and Review of the Literature

Sebaceous cell carcinoma (SCC) is the second most common eyelid malignancy among Caucasians, next to Basal cell carcinoma (BCC). It is an uncommon malignant neoplasm, and there are several reports describing the multiple clinical and histopathological presentations of SCC. Given its rarity, diagnosing SCC remains a challenge for ophthalmologists and pathologists, especially when conducting incisional biopsies. A 66-year-old male presented with a recurrent right upper eyelid mass for 4 years. The lesion recurred 4 times, and a biopsy was performed twice. In the first biopsy, a mild cell atypia was observed; the second biopsy was negative for atypia or cancerous cells. The patient was followed-up closely and in the 4th recurrence, a full thickness biopsy was performed. Histopathologically, areas of well-differentiated SCC were observed, as well areas of poorly differentiated SCC resembling BCC, squamous cell carcinoma in situ, and mucoepidermoid carcinoma. We highly recommend clinical and pathological suspicion of SCC in clinical cases of recurrent chalazion, treatment-resistant blepharoconjunctivitis, and undifferentiated malignant tumors of the eyelid present late in life.

Sebaceous Gland Carcinoma Masquerading as a Chalazion in a 18 Year Old Girl

Neoplasms of the sebaceous glands may masquerade as benign lesions resulting in delay in diagnosis. Their presentation may vary from sebaceous cell adenoma to sebaceous cell carcinoma. Worldwide, sebaceous cell carcinoma is the second most common eyelid malignancy after basal cell carcinoma. It commonly occurs in seventh decade of life. We report the clinical and histopathological findings of an 18-years-old girl presenting to us with sebaceous cell carcinoma in absence of any predisposing factors.

Extraocular sebaceous carcinoma of neck: A case Report

Context: Sebaceous cell carcinoma is a malignant neoplasm, rarely recognized in extra ocular sites. This neoplasm is aggressive in 29% of patients, lymph node and visceral metastasis are common. Its prognosis depends on early diagnosis of lesion. Clinical & Diagnostic features: An 49 year old female had slow growing nonulcerative subcutaneous nodule on the nape of neck of 9 months duration. On FNAC cytological findings favoured a benign skin adenexal tumor with focal nuclear atypia. On histological examination it was diagnosed as a poorly differentiated sebaceous carcinoma. Conclusion: Extra ocular sebaceous carcinoma is a rare neoplasm. It is difficult to diagnose as it has diverse clinical presentations, histologic patterns and complicated nomenclature. We will discuss the incidence, clinical, and histological findings along with the prognosis of this aggressive neoplasm. Keywords: Extra-ocular, Sebaceous cell carcinoma, Histopathology

Apocrine hidrocystoma of eye lid mimicking as sebaceous cell carcinoma

Apocrine hidrocystoma of eye lid mimicking as sebaceous cell carcinoma

Periocular Sebaceous Cell Carcinoma Following Chemical Burn

This study reports a unique case of a Marjolin ulcer in a patient who presented with periocular sebaceous cell carcinoma 16 years after a lye chemical burn. A 68-year-old woman presented with a long history of irregular and tender right upper and lower eyelid margins, periocular erythema, madarosis, trichiasis, ptosis, and chemosis, occurring many years after chemical burn to the area. After eyelid biopsy established the diagnosis of sebaceous cell carcinoma, subsequent map biopsies of the conjunctival surface revealed extensive sebaceous cell carcinoma with pagetoid spread, necessitating anterior exenteration for definitive treatment. This report describes the first case in which a sebaceous cell carcinoma has arisen in the area of a chemical burn. Sebaceous cell carcinomas should be included in the spectrum of Marjolin ulcers, and ophthalmologists should be aware of this entity when evaluating patients with a history of a burn to the eyelids.

Sebaceous Carcinoma of Lacrimal Caruncle in a Chinese Patient

To describe a case of sebaceous carcinoma of the caruncle and review relevant literature to raise awareness about this rare disease. A 63-year-old Chinese man presented with a nontender mass that had developed within the right lacrimal caruncle more than 3 years previously and had been growing in size. The patient was admitted to the hospital, and no systemic diseases were noted on physical and instrumental examinations. The mass was removed intact, and 10 small map biopsies of the surrounding conjunctiva and deeper tissues were performed. Thereafter, 0.04% mitomycin C was applied to the surgical defect for 5 minutes before repair by conjunctival autografting. The gross specimen was observed to be firm and yellow. Microscopic examination revealed that the tumor consisted of lobules, composed of pleomorphic vacuolated cells with central necrosis. The pathologic diagnosis was a well-differentiated sebaceous cell carcinoma of the caruncle that did not extend to the deep surgical margins. Moreover, no tumor recurrence was noted 12 months after surgery. The occurrence of sebaceous cell carcinoma in the caruncle is rare. In general, this neoplasm is often both clinically and histopathologically misdiagnosed as a benign condition, resulting in both a delay in correct diagnosis and increased morbidity and mortality. Therefore, this malignancy should be considered in the differential diagnosis of caruncular lesions. The suspected neoplasm should be removed by margins that are as wide as possible; map biopsies are considered to be useful to rule out the subclinical spread of the tumor.

Expression Patterns of Gli-1, Pleckstrin Homology-Like Domain, Family A, Member 1, Transforming Growth Factor-β1/β2, and p63 in Sebaceous and Follicular Tumors.

BackgroundCertain epidermal appendage tumors, including hyperplasias (hamartomas), adenomas, benign epitheliomas, primordial epitheliomas, and malignant tumors, can exhibit any stage of differentiation. Several molecules associated with tumorigenesis, such as Gli-1, pleckstrin homology-like domain, family A, member 1 (PHLDA-1), transforming growth factor (TGF)-β1, TGF-β2, and p63, are associated with tumor grade and aggressive behavior in follicular and sebaceous tumors in ways that are not well understood.ObjectiveThe aim of this study was to elucidate the expression of Gli-1, PHLDA-1, TGF-β1/β2, and p63 in benign and malignant tumors of the hair and sebaceous glands and to determine their importance in the degree of tumor differentiation.MethodsImmunohistochemistry was performed in follicular and sebaceous tumors using antibodies against Gli-1 (sebaceous tumor marker), PHLDA-1 (hair follicle outer root sheath [ORS] cell marker), p63, TGF-β1, and TGF-β2.ResultsGli-1 was expressed in basaloid cells, sebocytes, and sebaceous carcinoma cells, and expression levels decreased as differentiation progressed. PHLDA-1 was expressed in ORS cells and some follicular tumor cells. Expression of p63 was observed in the nuclei of the outermost basaloid cells (seboblasts), poorly differentiated sebaceous carcinoma cells, and tumor cells toward the direction of the hair. Remarkably, TGF-β1 was expressed exclusively in the nuclei of benign and malignant follicular (hair) tumors, but not in sebaceous tumors, at levels that correlated with the degree of differentiation.ConclusionWe propose that p63 and/or TGF-β1 are useful for predicting the degree of differentiation and malignant potential of sebaceous and follicular tumors and for distinguishing trichilemmal carcinoma from sebaceous carcinoma.

Sebaceous carcinoma over cheek: A rare presentation

Sebaceous carcinoma, an uncommon cutaneous tumor first described by Allaire in 1891. This arises mostly from sebaceous glands in the skin and thus may arise anywhere in the body where these glands exist. Approximately, 75% of these tumors arise in the periocular region, which is rich in sebaceous glands. Fewer than 120 cases of sebaceous cell carcinoma have been reported at the extraocular sites as in our case.

Rare Tumour - Sebaceous Carcinoma of the Scalp

Sebaceous carcinoma (SC) is a rare carcinoma arising from sebaceous gland divided into ocular and extra ocular. Ocular SC is more common than extra ocular. This tumour has a high incidence of recurrence and metastasis. Due to its rarity, it is often difficult to arrive to a diagnosis. Early diagnosis and treatment is crucial. Definitive diagnosis is only by histopathological examination. We are presenting a case of sebaceous carcinoma arising from the scalp. I. Introduction Sebaceous carcinoma (SC) is a rare aggressive malignant tumour derived from the adnexal epithelium of sebaceous glands. It is most commonly seen in the orbital region(2). Extra orbital sebaceous cell carcinoma is extremely rare which commonly occurs on head and scalp due to the abundant sebaceous glands(3). Most sebaceous gland carcinomas have no obvious aetiology and only a few are associated with Muir-Torre syndrome(MTS). This tumour is thought to arise from sebaceous glands in the skin and thus, may crop up anywhere in the body, where these glands exist including the genitalia. SCtraditionally classified into 2 groups, those arising from the ocular adnexa, particularly the Meibomian glands and glands of Zeiss, and those arising in extra ocular sites(4). Ocular SC represents 0.2% to 0.8% of all eyelid tumours and 1% to 5.5% of all eyelid malignancies(6). It is estimated that approximately 25% of all reported cases of sebaceous carcinoma occur in extra ocular site. It has been reported that more than 70% of sebaceous carcinomas are located in the head and neck regions, where sebaceous glands are most commonly located (5).These tumours have a high incidence of local recurrence and regional metastasis. Earlydiagnosis is crucial in reducing the morbidity and mortality associated with the tumour(6). This is a case report of an elderly manwith a sebaceous carcinoma of the scalp.

Overview of conjunctival and eyelid tumours

AbstractIn this part of the course an overview will be given of the most common and most important conjunctiva and eyelid tumors ( basal cell carcinoma, squamous cell carcinoma, sebaceous cell carcinoma, malignant melanoma). For each disease clinical‐pathologic correlations will be emphasized. Typical and atypical characteristics will be shown. In most cases the clinician finds the correct diagnosis, but even then it is important to investigate the section margins and the degree or details of the tumor. In rare cases a surprise in diagnosis is found and some important examples of these will be given, with also the useful consequences on the clinical follow‐up of these patients. Correct diagnosis can also be useful in non‐malignant processes and examples will be given. A short overview will be given of newer techniques and diagnostic possibilities.

Population‐based analysis of prognostic indicators in sebaceous carcinoma of the head and neck

Due to the rarity of sebaceous carcinoma of the head and neck, few large series have been reported and prognostic factors remain largely undetermined. This study presents prognostic factors in survival in sebaceous carcinoma of the head and neck. Retrospective analysis was performed using the Surveillance Epidemiology and End Results (SEER) database for patients diagnosed with sebaceous carcinoma of the head and neck (SCHN). Clinicopathologic, treatment data, and 5-year disease specific survival were analyzed using univariable and multivariable regression analysis and Kaplan-Meier methodology. Of the 1,433 patients identified to have SCHN, 16 were node-positive (1.14%). On multivariable analysis, independent prognostic indicators were: age at diagnosis (HR = 1.03, P = .021), tumor grade (HR = 4.97, P = .038), and distant metastasis (HR = 7.52, P = .006). Nodal metastasis occurred exclusively with poorly or undifferentiated tumors and was not a significant prognostic factor on multivariable analysis. Elderly patients and patients with poorly differentiated tumors and/or distant disease at presentation have the highest risk of disease-specific mortality. Lymph node metastasis does not appear to be an independent prognostic factor in sebaceous cell carcinoma.

Postauricular sebaceous cell carcinoma

Introduction: Sebaceous cell carcinoma is an aggressive tumor arising from the sebaceous glands. It is relatively rare tumor and seen almost exclusively on the eyelids (75%). Despite the high concentration of sebaceous glands over head and neck region, true neoplasm, i.e. sebaceous cell adenoma and carcinomas are infrequent. It accounts for just 0.2–0.7% of all eyelid tumors in USA and very few cases that have originated in areas other than the eyelids have been reported. Case Report: A 70­year­old male presented with complaints of rapidly growing swelling (3x4 cm), on the right post auricular region, since one and half months. The patient developed discharging ulcer over the swelling associated with progressive tinnitus and hoarseness of voice, since last twenty days. Fine needle aspiration cytology (FNAC) was advised, which suggested the diagnosis of sebaceous cell carcinoma and excision biopsy was done. Histopathological examination of excised tissue confirmed the diagnosis. Conclusion: Extraorbital sebaceous cell carcinoma is an aggressive and invasive malignancy. It clinically mimics other diseases and is difficult to diagnose. Hence, an accurate and prompt diagnosis is crucial because of its fulminant course, serious associations with Muir–Torre syndrome and high potential for regional and distant metastasis.

Sentinel Lymph Node Biopsy in Malignant Eyelid Tumor: Hybrid Single Photon Emission Computed Tomography/Computed Tomography and Dual Dye Technique

To study the utility of hybrid single photon emission computed tomography / computed tomography (SPECT/CT) scan and dual-dye technique in identification of the sentinel lymph node (SLN) in patients with an advanced malignant eyelid tumor. Nonrandomized prospective interventional study. setting: A tertiary eye care center. study population: Patients with an advanced malignant eyelid tumor without clinically involved regional lymph nodes. intervention: SLN biopsy was performed using dual-dye technique (a combination of radiotracer and vital blue dye) following localization by SPECT/CT. main outcome measures: Localization of SLN in the regional node basin by hybrid SPECT/CT scan; SLN identification rate using dual-dye technique; SLN positivity rate; false-negative rate; and complications, if any, of SLN biopsy. Sixteen patients of biopsy-proven eyelid malignancy (7 squamous cell carcinomas [43.75%], 5 sebaceous cell carcinomas [31.25%], and 4 malignant melanomas [25%]) were included in the study. Preoperative localization of SLN was performed using SPECT/CTin 12 patients. SLN biopsy using dual-dye technique was performed in 16 patients. SPECT/CT accurately localized SLN in 11 out of 12 patients. The preauricular region was the most common site of SLN. SLN identification rates for dual-dye, radiotracer, and blue dye techniques were 100% (16/16 patients), 100% (16/16 patients), and 87.5% (14/16 patients), respectively. SLN showed metastasis in 2 patients (12.5%). On follow-up, 1 patient developed cervical lymph node metastasis, thus giving a false-negative rate of 7.14%. There were no complications associated with SLN biopsy. Accurate preoperative localization of SLN in relation to adjacent anatomic structures using SPECT/CT aids in intraoperative identification of SLN. SLN biopsy should be considered in patients with eyelid tumors at significant risk for metastasis who have clinically negative nodal basins. Dual-dye technique is safe and feasible in advanced eyelid tumors. Blue dye technique can be used for SLN biopsy in settings where nuclear medicine facilities are not available, albeit with a lower SLN identification rate. Detection of metastasis in SLNs in ∼12% of cases emphasizes the utility of SLN biopsy in accurate staging and treatment of eyelid malignancies.

Need for Lacrimal Bypass Surgery after Medial Canthal Tumor Resection: Survey of Current Practices

Objective: No ideal monitoring period exists before conjunctivodacryocystorhinostomy (CDCR) after excision of medial canthal tumors. This study seeks to define current clinical practices via a survey of oculoplastic and orbital surgeons. Methods: An online survey of medial canthal tumor management was offered via email to ASPORS members. Tumors included: basal cell carcinoma (BCC), squamous cell carcinoma (SCC), sebaceous cell carcinoma (SebC), melanoma (M), keratoacanthoma (KAC), and other adnexal cancers. Results: 87 members responded. Most surgeons follow patients at intervals no longer than 3-6 months, with monthly exams initially for SebC (17%) and M (20%). > 85% of surgeons follow asymptomatic patients for >12 months before release, with many observing >60-month periods for BCC (29%), SCC (36%), SebC (57%), M (68%), and KAC (23%). 92% of respondents defer CDCR; the majority wait >12 months for all tumors before CDCR. A majority (53%) reported at least 75% of patients developing symptomatic epiphora requiring CDCR. The majority of surgeons (73%) do not perform ancillary testing before CDCR, and 53% perform pre-operative imaging. However, 14% have experienced local or orbital tumor recurrence following CDCR. Conclusions: SebC and M follow-up intervals trend shorter, while most respondents follow these tumors post-excision > 5 years. > 25% of surgeons follow all tumors for > 60 months. CDCR is delayed for > 12 months by > 75% of surgeons for all tumors. 8% perform CDCR at the time of excision, and 14% reported local/orbital recurrence following CDCR with 52% obtaining pre-CDCR imaging. These results support extended follow-up before CDCR combined with appropriate imaging/testing to minimize morbidity/mortality.

Imaging of eyelid lymphatic drainage

PurposeTraditional descriptions of lymphatic drainage show eyelids emptying into the submandibular or preauricular basin. However recent studies based on in vivo lymphatic imaging show a possible predilection for the preauricular basin. We describe lymphoscintigraphy and report findings in patients with eyelid malignancies undergoing sentinel lymph node biopsy (SLNB). MethodsRetrospective chart review of 15 consecutive patients at a single institution with eyelid carcinoma undergoing SLNB. The primary outcome measure was primary facial lymphatic drainage site from the eyelid as determined by lymphoscintigraphy. ResultsThe preauricular basin was the site of focal radioactive uptake in all 15 patients. The location of the primary tumor was as follows: medial upper eyelid (1), medial canthus (3), medial lower eyelid (3), lateral upper eyelid (3), and lateral lower eyelid (5). The types of tumor were: invasive squamous cell carcinoma (7), malignant melanoma (3), and sebaceous cell carcinoma (2), Merkel cell carcinoma (2), and conjunctival spindle cell carcinoma (1). ConclusionsLymphoscintigraphy is increasingly used in the context of SLNB for periocular malignancy. The recent literature suggests that the preauricular lymph node basin may be the primary site of eyelid lymphatic drainage and this is corroborated by our series. Further data will elucidate the biology of eyelid lymphatic channels in humans but the preauricular basin may be the prime lymphatic metastastic site in eyelid malignancies.

Combined excision and intralesional bevacizumab for sebaceous carcinoma of the eyelid in an Amur tiger (Panthera tigris altaica)

An 18-year-old zoo-kept female Amur tiger presented with an approximately 5 mm diameter lateral canthal eyelid mass in the left eye which grossly appeared red and irregular. The mass was completely excised via lateral canthoplasty. Histopathologic evaluation was consistent with a diagnosis of sebaceous cell carcinoma, which is a potentially aggressive cutaneous neoplasm. The sebaceous carcinoma recurred within 3 months and slowly increased in size until a second surgical excision was performed 9 months following the first surgery. The second surgical excision was combined with intralesional injection of 10 mg of the antiangiogenic drug bevacizumab. Histology confirmed the diagnosis. The tiger was euthanized 16 months postoperatively for reasons unrelated to, and without recurrence of, the eyelid neoplasm. At postmortem, no gross periocular or metastatic lesions were noted, and histopathology of the lateral canthus provided no evidence of recurrence. Surgical excision combined with intralesional bevacizumab treatment induced life-long resolution of the sebaceous carcinoma. Bevacizumab treatment may be associated with the regression of periocular angiogenic proliferative conditions, including neoplasia, by inhibiting angiogenesis.

Trichoadenoma of an Eyelid in an Adult Mimicking Sebaceous Cell Carcinoma

The purpose of this report is to detail the clinical and histologic findings of a rare trichoadenoma of the eyelid. A 63-year-old male with a recurrent left lower eyelid lesion underwent a shave biopsy with inconclusive results until referred to an oculoplastic surgeon. The patient presented with a lesion suspicious for sebaceous cell carcinoma of the eyelid. An excisional biopsy was performed, and the specimen was sent for permanent section histologic analysis. The results revealed the lesion to be a trichoadenoma of the eyelid. The remaining lesion was excised, and the lower eyelid was reconstructed.

Locally Advanced Sebaceous Cell Carcinoma (T3) of Eyelid: Incidence and Pattern of Nodal Metastases and Combined Modality Management Approach

Background: Sebaceous carcinoma (SbCC) is a rare malignancy that often mimics benign conditions. Lymphatic involvement, large T3 tumors herald a dismal survival for patients. We present our series of 13 cases of locally advanced SbCC of the eyelid treated at a surgical oncology unit and describe the clinical profile, patterns of nodal spread and recurrence pattern in this subset of SbCC.Methods: A retrospective analysis of case records was carried out for patients presenting with orbital tumors between January 1997 and April 2010 in the department of Surgical Oncology, AIIMS, New Delhi, India. All patients underwent orbital exenteration and superficial parotidectomy with neck dissection was added to patients with clinically significant lymphadenopathy. All patients who underwent OE after 2002 were advised radiotherapy as adjuvant therapy. The end point was development of recurrence or end of two year follow up period which ever occurred earlier.Results: Thirteen patients underwent orbital exenteration. Eleven patients had clinically palpable lymphadenopathy. Ten patients (76.9%) had pathologically confirmed metastatic nodes. Parotid lymph node involvement was present in all patients (100%); two of these ten patients also had level II b cervical lymph node involvement. Recurrence was observed in seven patients (53.8%). All recurrences were loco-regional only and no systemic metastases was seen. There were only two recurrences in the group that received PORT.Conclusions: Eyelid SbCC is a loco-regionally aggressive malignancy and adequate disease control can be achieved with combined modality approach of radical surgery followed by post operative radiotherapy.