• Archives of Craniofacial Surgery
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• v.15 no.1
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• pp.32-35
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• 2014

Sebaceous carcinoma is a rare malignant tumor differentiated from the adnexal epithelium of sebaceous glands and forms less than 1% of all cutaneous malignancies. We present a case of a 93-year-old woman with a rapidly growing mass on the right cheek. Initial histiopathologic finding was basal cell carcinoma. The mass was widely excised and superficial parotidectomy was performed while preserving the facial nerve branches. The resulting defect was covered with a transposition flap from the ipsilateral posterior auricular area and the donor site was closed primarily. However, histopathologic examination of the excised mass showed a poorly differentiated sebaceous carcinoma with a clear resection margin. The diagnosis of sebaceous carcinoma can be difficult to make at initial presentation. This report describes a rare case of a rapidly growing extraocular sebaceous carcinoma, which resulted in a good treatment outcome, and provides a review of relevant literature.

• Archives of Plastic Surgery
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• v.36 no.3
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• pp.361-364
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• 2009

Purpose: Sebaceous carcinoma is a rare malignant tumor derived from the adnexal epithelium of sebaceous glands. This tumor usually occurs on the eyelids, but uncommonly it may occur on the extraocular sites. It is characterized by a tendency of local recurrence and occasional metastasis. Surgical excision is appropriate treatment for patients with sebaceous carcinoma. Because this kind of case is rare, we report two cases of sebaceous carcinoma developed on scalp. Methods: Case 1 was a 69 - year - old woman. She visited the hospital with a $1.5{\times}2.5cm$ sized reddish yellow - colored, slowly growing mass on left parietal scalp. The mass began at birth and started growing at 5 years ago. Case 2 was a 67 - year - old woman. She had $2.5{\times}3.0cm$ sized yellow - colored mass on right parietal scalp. It occured at birth and started growing at 3 years ago. And the masses had erythematous ulcer with sanguineous discharge. In the beginning, the masses were miliary nodule. Results: CT scan and fine needle biopsy were done. Case 1 and 2 were diagnosed as sebaceous carcinoma. Wide excision with safety margin of 10 mm and split thickness skin graft was done. Histological examination revealed well demarcated, irregular, variable sized tumor lobules. Each lobule was composed of sebaceous and undifferentiated cells. Postoperatively, the patients did well and the lesion had not recurred. Conclusion: Sebaceous carcinoma is an aggressive malignant tumor. It often can be mistaken for other skin tumors. Authors experienced two rare cases of sebaceous carcinoma developed on scalp. We recommend early wide excision with enough safety margin as treatment of sebaceous carcinoma.

• Archives of Plastic Surgery
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• v.34 no.4
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• pp.493-494
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• 2007

Purpose: Nevus sebaceous is a distinctive growth commonly found on the scalp, forehead and retroauricular region. Nevus sebaceous has age-related changes in morphologic and histologic appearance. Secondary neoplasm including basal cell carcinoma is found in 20% of the nevus sebaceous which were not treated properly. So, we report a case of basal cell carcinoma that is arising in nevus sebaceous but has no malignant appearance. Methods: A 38 year-old female patient wanted to excise the lesion on scalp. It looked like typical nevus sebaceous because we didn't find any malignant appearances. We excised the lesion including minimal normal tissue. Results: After the excision of the lesion, pathologist reported the nevus sebaceous with multifocal basal cell carcinoma. Conclusion: Many patients want to excise the nevus sebaceous that stands out to other people. But they don't know the potency of malignant changes. So, plastic surgeons have to notify the potency and make plan for proper treatment.

• Archives of Craniofacial Surgery
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• v.11 no.1
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• pp.58-61
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• 2010

Purpose: Sebaceous carcinoma is a rare malignant tumor that occurs mostly in head and neck regions. Early diagnosis and treatment are necessary because it tends to be locally aggressive and goes through distal metastasis with fast progression. This study presents reliable surgical methods for sebaceous carcinoma in head and neck regions. Methods: Three patients were included in this study. First, a 61-year-old woman visited the hospital with a yellow-colored, slowly growing mass on the left ala. A 54-year-old woman had a brown-colored mass on her right preauricle. Last case was a 62-year-old man who had a yellow-colored mass on his scalp. CT scan and punch biopsy were done. All cases were diagnosed as sebaceous carcinoma. The lesions were resected with 10 mm safety margin and various regional flaps were used for reconstruction. Results: Histological examination revealed sebaceous differentiation and local invasions. Postoperatively, all patients did not suffer from complication and no recurrence was found. Conclusion: We recommend early wide excision with an enough safety margin, and a regional flap as a treatment of sebaceous carcinoma.

• Korean Journal of Head & Neck Oncology
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• v.36 no.2
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• pp.21-25
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• 2020

Sebaceous carcinoma is a relatively rare and aggressive malignant tumor. Periocular area (especially eyelid) is the most common lesion to occur, and the most common extraocular lesion is the parotid gland. Because the lesion also mimic other benign inflammatory diseases, this leads to delayed diagnosis or misdiagnosis. Here, we report a 58-year-old male patient who presented with a non-tender painless left parotid mass after wide excision of sebaceous carcinoma in the left eyelid two years ago. When he was diagnosed with sebaceous carcinoma of left eyelid, there was a small left parotid tumor on the computed tomography. But no further examination and treatment were performed. Two years later, physical examination revealed growing parotid tumor and multiple neck nodes on the left side. After radical parotidectomy and neck dissection, histological examination showed a sebaceous carcinoma and neck node metastasis. Considering the aggressiveness of sebaceous carcinoma, further evaluation for parotid glands should be considered when sebaceous carcinoma of the eyelid was discovered. Postoperative chemoradiotherapy was performed for disease control. Follow up after two years, and computed tomography showed no sign of recurrence.

• Korean Journal of Head & Neck Oncology
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• v.38 no.1
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• pp.37-41
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• 2022

Sebaceous carcinoma is extremely rare in the parotid gland. Recently, we experienced a case of carcinoma with sebaceous differentiation arising from the parotid gland in patient who was diagnosed as parotid adenoma carcinoma and underwent total parotidectomy. A 73-year-old male visited our department for the evaluation of 3-month history of infra-auricular mass combined with pain. Radiologic finding showed lobulated enhancing and solid mass with calcification in the right parotid gland. Initially, total parotidectomy with supraomohyoid neck dissection was performed. Pathological findings showed capsulated whitish mass with hemorrhage and cystic degeneration. Immunohistochemically, CK7, CK5/6, p63 were positive and CEA was negative. The intra-operative frozen section diagnosis was mucoepidermoid carcinoma. The permanent diagnosis was changed to adenocarcinoma, NOS(not otherwise specified). Fourteen months later, the newly developed mass was noticed on the operation bed. The mass was clinically diagnosed as recurred adenocarcinoma. Revision parotidectomy was performed and pathological findings revealed that the tumor was newly developed sebaceous carcinoma. We report a case of carcinoma with sebaceous differentiation in parotid gland with a review of literature.

• Archives of Craniofacial Surgery
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• v.13 no.1
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• pp.76-79
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• 2012

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.

• Archives of Craniofacial Surgery
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• v.14 no.1
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• pp.65-68
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• 2013

Muir-Torre syndrome is defined by concurrent or sequential development of internal malignancy and sebaceous neoplasm or multiple keratoacanthomas. Muir-Torre syndrome is very rare, with only 205 cases reported in the literature. We reported a patient with Muir-Torre syndrome with three internal malignancies. A 64-year-old patient with a history of breast cancer, stomach cancer and colon cancer visited our department for treatment of the skin lesion that occurred five years before on the left cheek. The lesion was excised completely with a resection margin of 1 cm, followed by full-thickness skin graft from left postauricular area for reconstruction. Histopathology revealed a $0.2{\times}0.2{\times}0.1cm$ sized sebaceous carcinoma with 4 mm safety margin. The skin graft was well taken within 7 days after surgery and the patient was discharged to outpatient follow-up. There was no complication related with surgery. Muir-Torre syndrome is very rare, as are sebaceous gland tumors. So if a cancer of the sebaceous gland is diagnosed, screening workup for internal malignancy is recommended. Because of its good prognosis, surgical removal of primary or metastatic cancers may be curative and should be attempted where possible.

• Archives of Craniofacial Surgery
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• v.22 no.2
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• pp.126-130
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• 2021

Sebaceous neoplasms are rare adnexal tumors that can present a challenge to clinicians. Only four cases of sebaceous carcinoma with sebaceoma have been reported in the literature. Herein, we describe the case of a sebaceous carcinoma originating from a sebaceoma in a solitary nodule of the posterior neck. Immunohistochemically, the tumor cells were strongly positive for epithelial membrane antigen and p53. It is possible that adnexal carcinomas may arise from malignant transformation of their benign counterparts as well as de novo. Malignant transformation was likely in this case because the lesion was composed of distinct benign and malignant components, and the benign component showed the typical histopathological features of sebaceoma. This case underscores the fact that partial and superficial biopsies sometimes may not provide the correct diagnosis. If a surgeon suspects malignancy based on a clinical examination, then it is mandatory to perform a deep biopsy.

• Archives of Craniofacial Surgery
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• v.22 no.1
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• pp.56-61
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• 2021

Sebaceous carcinoma (SC) is a rare tumor, accounting for approximately 0.7% of skin cancers. SC can be classified as ocular SC (OSC) or extraocular SC (EOSC) depending on its location. Because EOSC accompanied by metastases is rare, there is a paucity of data about EOSC accompanied by metastasis. This study presents a case of an aggressive EOSC of the scalp with lymph node metastases. The patient underwent wide local excision of the primary tumor with a 1 cm safety margin and bilateral radical lymph node dissection. However, recurrence was observed 1 month after surgery. Radiation therapy and resection were performed for the recurrent tumor. However, distant metastases to both lungs eventually occurred. Here, we describe a rare recurrent case of EOSC of the scalp with distant organ metastasis with a review of the literature.