Archives of Craniofacial Surgery (대한두개안면성형외과학회지)
- Volume 13 Issue 1
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- Pages.76-79
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- 2012
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- 2287-1152(pISSN)
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- 2287-5603(eISSN)
DOI QR Code
A Giant Sebaceous Epithelioma on the Scalp: A Case Report
두피에 발생한 거대 피지샘 상피종 1례
- Kim, Eun Yeon (Department of Plastic and Recontructive Surgery, Gachon University Gil Hospital) ;
- Kim, Sun Goo (Department of Plastic and Recontructive Surgery, Gachon University Gil Hospital) ;
- Kim, Yu Jin (Department of Plastic and Recontructive Surgery, Gachon University Gil Hospital) ;
- Lee, Se Il (Department of Plastic and Recontructive Surgery, Gachon University Gil Hospital)
- Received : 2011.08.19
- Accepted : 2011.12.29
- Published : 2012.04.09
Abstract
Purpose: Sebaceous epithelioma (sebaceoma) is a benign tumor with sebaceous differentiation. It presents primarily as a yellowish papule or nodule on the face and scalp. It must be differentiated from basal cell carcinoma and other appendageal tumors. We report a giant sebaceous epithelioma on the scalp and describe the immunohistochemical character of the cells in sebaceous epithelioma to epithelial membrane antigen (EMA). Methods: A 55-year-old-man who presented with 5-cm-diameter 2-cm-height, round shape exophytic ulcerated tumor on his head presented for treatment. The patient had noticed the lesion 40 years prior as a small yellowish plaque and 18 months ago, the plaque started to grow progressively larger. We excised the lesion with 1 cm resection margin, considering the possibility of malignancy because this lesion grossly resembled basal cell carcinoma (BCC). The defect was repaired with the use of a splitthickness skin graft. Results: When we excised the lesion, the margin was clear. Histology showed nodules that consisted of an admixture of basaloid cells and mature adipocytes lacking an organized lobular architecture. Strong expression of EMA on mature adipose cells confirmed the differential diagnosis from BCC with sebaceous differentiation because of the absence of a nuclear palisade pattern and cleft-like spaces on the hematoxylin and eosin (H&E) section. Conclusion: We treated the giant sebaceous epithelioma on the scalp with surgical excision and a split-thickness skin graft. It is important to know that the diagnosis of sebaceous epithelioma should be made based on the histologic pattern of the H&E section. Immunohistochemistry with EMA can help to confirm the differential diagnosis between sebaceous epithelioma and BCC.