SEBACEOUS CARCINOMA

By Gary M. White, MD


The sebaceous carcinoma is a rare and aggressive tumor which occurs most commonly about the eyes. It arises most commonly from the Meibomian glands of the tarsus, which are more numerous on the upper eyelids.

Clinical

The sebaceous carcinoma may present as a painless papulonodule along the eyelid--usually the upper. It may initially be misdiagnosed as a recurrent chalazion, a morpheaform BCC or chronic blepharoconjuctivitis. Multi-centric origin is not uncommon and both upper and lower lids may be affected. Approximately 25% of sebaceous carcinomas are extraocular.

Diagnosis

A full thickness biopsy may be necessary for diagnosis.

Muir Torres Syndrome

The presence of sebaceous carcinoma should prompt the consideration of Muir Torre syndrome which is the association of sebaceous neoplasms with low grade visceral carcinomas and keratoacanthomas. Have the pathologist look for micro satellite instability.

Treatment

Moh's surgery is usually performed for facial lesions followed by reconstructive surgery. Orbital exenteration may be needed. Frequent follow up is important. For lesions elsewhere, an excision with 1 cm margins is often done.

References

77-year-old man a 7.5 cm × 8 cm plaque on the abdomen. Moon TC, Cassler NM, Lackey JN. Sebaceous carcinoma on the abdomen in an African-American male patient. Indian Dermatol Online J 2015 ;6, Suppl S1:27-9.

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