J Korean Med Sci.  2017 Aug;32(8):1351-1359. 10.3346/jkms.2017.32.8.1351.

Sebaceous Carcinoma: Clinicopathologic Analysis of 29 Cases in a Tertiary Hospital in Korea

• Park SK
• Park J
• Kim HU
• Yun SK

• KMID: 2439471
• DOI: http://doi.org/10.3346/jkms.2017.32.8.1351

Abstract

Sebaceous carcinoma (SC) is a neoplasm derived from the adnexal epithelium of the sebaceous glands, and most studies on this neoplasm have been conducted in Caucasians. We retrospectively reviewed the records of 29 patients with SC (16 extraocular and 13 ocular lesions) who were diagnosed from 2001 to 2014 to analyze the clinical and histopathological features of SC in the Korean population. Sixteen of the patients were women and 13 were men. There was an equal sex distribution for extraocular lesions, and a female predilection (M:F = 1:1.6) for ocular lesions. The mean ages at presentation of extraocular and ocular lesions were 69.19 ± 37.19 (range, 32-87) and 67.46 ± 24.46 (range, 43-85) years, respectively. Most lesions occurred in the eyelid (13/29, 44.83%), and most extraocular lesions occurred in the head and neck area (13/16, 81.25%). There was no recurrence or death during the follow-up period. Most lesions were poorly differentiated (extraocular, 43.75%; ocular, 38.46%), had a lobular infiltrative growth pattern (extraocular, 68.75%; ocular, 76.92%), and were basaloid (extraocular, 56.25%; ocular, 61.54%). Only 5 cases (2 extraocular and 3 ocular lesions) showed pagetoid spread. Extraocular lesions were marginally more common than the ocular form. There were higher incidences in elderly patients, who also had the highest incidence of eyelid lesions. The proportion of cells with sebaceous differentiation and prominent growth patterns were variable. Our results show that SC may not be very aggressive in Koreans.

Keyword

Clinical; Extraocular; Ocular; Pathology; Sebaceous Carcinoma

MeSH Terms

Aged
Epithelium
Eyelids
Female
Follow-Up Studies
Head
Humans
Incidence
Korea*
Male
Neck
Pathology
Recurrence
Retrospective Studies
Sebaceous Glands
Sex Distribution
Tertiary Care Centers*

Figure

• 

  Fig. 1 Age distribution of patients with extraocular and ocular SCs. SC = sebaceous carcinoma.

• 

  Fig. 2 Clinical presentations of extraocular SC. (A) Light-pink hard nodule on the forehead. (B) Deep-brown crusted nodule on the right cheek. (C) Light-brown nodule on the right parietal scalp. (D) Light-pink hard nodule with ulceration on the scrotum. (E) Red pedunculated nodule with ulceration on the left cheek. (F) Flesh-colored crusted plaque on the left neck. SC = sebaceous carcinoma.

• 

  Fig. 3 Clinical presentations of ocular SC observed using slit-lamp biomicroscopy. (A) Yellow papule on the left upper eyelid. (B) Yellow confluent papules on the conjunctival side of the right upper eyelid. (C) Flesh-colored papule on the right upper eyelid. (D) Off white-colored nodule on the left caruncle. SC = sebaceous carcinoma.

• 

  Fig. 4 Histopathological observation of SC. (A) Well-differentiated SC with sebocyte-like tumor cells (H & E, × 100). (B) Moderately differentiated SC (H & E, × 100). (C) Poorly differentiated SC with fine stippling of the nuclear chromatin and few mitoses present (H & E, × 200). (D) Lobular pattern of infiltrative growth with central necrosis (H & E, × 100). (E) Trabecular pattern of infiltrative growth, and the inset shows an epidermoid dyskeratosis (H & E, × 100; inset, × 400). (F) Papillary pattern of infiltrative growth with unencapsulated margins (H & E, × 100). (G) Tumor cells surrounded by layers of basaloid cells (H & E, × 100). (H) Epidermoid infiltrative cell type with nonkeratinizing cells within a large lobule manifesting nonvacuolated eosinophilic cytoplasm with scattered pleomorphic nuclei in a comedonecrosis pattern (H & E, × 100). (I) Basosquamous infiltrative cell type with lobules composed of small cells with scant eosinophilic cytoplasm (H & E, × 100). (J) Intraepithelial tumor cells with a pagetoid spreading pattern (H & E, × 100). SC = sebaceous carcinoma, H & E = hematoxylin and eosin.

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