Basal Cell Carcinoma with Sebaceous Differentiation

Abstract

Some authors have used sebaceous epithelioma as a synonym for basal cell carcinoma (BCC) with sebaceous differentiation. However, our review of the literature revealed that definite cases of BCC with sebaceous differentiation that provide adequate clinical and histopathologic information are scarce. We present the case of a 72-year-old woman with a pigmented nodular lesion on her right ala nasi region, clinically diagnosed as pigmented BCC. Histopathologically, this nodular lesion, which was completely excised, showed typical features of BCC. It was noteworthy that within one aggregation of the presented BCC, tiny and small duct-like structures lined by cornified layers with a crenulated inner surface were seen. Vacuolated cells were scattered within a few aggregations, and they had foamy, bubbly cytoplasm and starry nuclei. The vacuolated cells were immunohistochemically positive for epithelial membrane antigen (EMA). These histopathologic findings demonstrated unquestionable sebaceous differentiation in this BCC, namely BCC with sebaceous differentiation, which should be distinguishable from both sebaceoma and sebaceous carcinoma. The small duct-like structures lined by eosinophilic cuticle, indicating apocrine differentiation, were also observed in this BCC.

Urothelial Carcinoma with shadow cell, lipid cell and sebaceous (skin adnexal) differentiation: Clinicopathological and immunohistochemical study of 10 cases

“…Sebaceous differentiation has not previously been identified in UCs and is a rare characteristic even in cutaneous carcinomas such as basal cell carcinoma [26]. In addition to ectodermal-origin skin and parotid gland neoplasms, a small number of cases have been reported in organs such as the uterine cervix and the larynx [15][16][17].…”

Histologic Mimics of Basal Cell Carcinoma

“…74 Although sebocytes and sebaceous ductlike structures have been identified in BCC (Figure 7, B), sebaceous lobular architecture is not observed. 99 Intraepidermal pagetoid spread is common in SC and is absent in BCC. 89,90 Peripheral clefting is typically absent in SC.…”

Infundibulocystic Structures and Prominent Squamous Metaplasia in Sebaceoma—A Rare Feature. A Clinicopathologic Study of 10 Cases

“…17,18 The divergent, multidirectional differentiation found in one and the same tumor entity is explained embryologically by the derivation of the sebaceous glands and hair follicles (and apocrine glands) from the common folliculosebaceous-apocrine unit. This dogma is used to explain the occurrence of dual or even tripartite (apocrine, follicular, and sebaceous) differentiation in cutaneous adnexal tumors.…”