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CASE REPORT |
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Year : 2014 | Volume
: 7
| Issue : 2 | Page : 250-251 |
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Sebaceous carcinoma over cheek: A rare presentation
Dakshayani S Nirhale, Amit Parasnis, Virendra S Athavale, Mohit Bhatia
Department of Surgery, Padmashree Dr D Y Patil Medical College, Hospital and Research Centre, Dr D Y Patil Vidyapeeth, Pimpri, Pune, India
Date of Web Publication | 4-Feb-2014 |
Correspondence Address: Mohit Bhatia 1, Bank Colony, Opposite Old Sessions Courts, Ambala City - 134 003, Haryana India
Source of Support: None, Conflict of Interest: None | Check |
DOI: 10.4103/0975-2870.126379
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. Keywords: Muir-Torre syndrome, sebaceous cell carcinoma, wide local excision
How to cite this article: Nirhale DS, Parasnis A, Athavale VS, Bhatia M. Sebaceous carcinoma over cheek: A rare presentation. Med J DY Patil Univ 2014;7:250-1 |
Introduction | | |
Sebaceous carcinoma, an uncommon cutaneous tumor first described by Allaire in 1891. [1] This arises mostly from sebaceous glands in the skin and thus may arise anywhere in the body where these glands exists. Sebaceous carcinoma is a dermally based and non-encapsulated basaloid tumor. [2] Sebaceous carcinoma is associated with a high degree of cytological atypia and mitotic activity. Sebaceous gland carcinoma, also called meibomian gland carcinoma, is a rare aggressive malignant tumor derived from the adnexal epithelium of sebaceous glands. The tumor may exhibit a myriad of clinical presentations and diverse histologic patterns, accounting for an initial misdiagnosis in approximately 50% of cases. [3] Although most cases of sebaceous carcinoma represent sporadic occurrences, the tumor may also present in the setting of the Muir-Torre syndrome and the diagnosis of a sebaceous carcinoma should prompt consideration of this genodermatosis, especially in the context of other sebaceous neoplasms or internal malignancies. [4]
Case Report | | |
A 65-year-old male patient presented with a non-tender swelling over right cheek. Swelling was firm, mobile, 3-4 cm in size [Figure 1]. Fine needle aspiration cytology reports showed scattered epithelial cells in hemorrhagic background. Cytological features suggested of poorly differentiated epithelial malignancy in the right cheek. Computed tomography scan revealed subcentrimetric lymph nodes at level 2 in the posterior triangle. Patient underwent wide local excision with modified radical lymph node dissection [Figure 2] and [Figure 3]. Histopathology (HPE) suggested malignant adnexal tumor mostly sebaceous carcinoma with metastatic deposits to submandibular lymph nodes after wide local excision [Figure 4].
Discussion | | |
Sebaceous cell carcinoma, an uncommon cutaneous tumor first described by Allaire in 1891. This arises mostly from sebaceous glands in 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. The most common site of origin is meibomian glands of the eyelids leading to meibomian gland carcinoma. [5] It exhibits an aggressive clinical course with the tendency for both local and distant metastasis. Intraepithelial spread or pagetoid spread is reported in 44-80% of cases. Pagetoid spread is the infiltration of single tumor cells or nests of tumor cells into the overlying epithelium. [6] Fewer than 120 cases of sebaceous cell carcinoma have been reported at the extraocular sites. [7]
Conclusion | | |
The treatment of sebaceous gland carcinoma is adequate surgical excision, with wide surgical margins and fresh frozen section controls to delineate the tumor edges. Lymph node evaluation is necessary to evaluate metastasis.
References | | |
1. | Nelson BR, Hamlet KR, Gillard M, Railan D, Johnson TM. Sebaceous carcinoma. J Am Acad Dermatol 1995;33:1-15. |
2. | Wick MR, Goellner JR, Wolfe JT 3 rd , Su WP. Adnexal carcinomas of the skin. II. Extraocular sebaceous carcinomas. Cancer 1985;56:1163-72. |
3. | Moreno C, Jacyk WK, Judd MJ, Requena L. Highly aggressive extraocular sebaceous carcinoma. Am J Dermatopathol 2001;23:450-5. |
4. | Cohen PR, Kohn SR, Davis DA, Kurzrock R. Muir-Torre syndrome. Dermatol Clin 1995;13:79-89. |
5. | Pereira PR, Odashiro AN, Rodrigues-Reyes AA, Correa ZM, de Souza Filho JP, Burnier MN Jr. Histopathological review of sebaceous carcinoma of the eyelid. J Cutan Pathol 2005;32:496-501. |
6. | Elder D, Elenitsas R, Ragsdale BD: Tumors of the epidermal appendages, in Elder D, Elenitsas R, Jaworsky C, Johnson Jr B (eds): Lever's Histopathology of the Skin, Lippincott-Raven, Philadelphia, 1997, pp 747-803. |
7. | Duman DG, Ceyhan BB, Celikel T, Ahiskali R, Duman D. Extraorbital sebaceous carcinoma with rapidly developing visceral metastases. Dermatol Surg 2003;29:987-9. |
[Figure 1], [Figure 2], [Figure 3], [Figure 4]
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