Metastatic extraocular sebaceous carcinoma with an occult primary

Abstract

The cytological diagnosis of sebaceous carcinoma is based on the aspiration of tumor lobules with extensive sebaceous differentiation. However, these tumors may show a spectrum of cells ranging from basaloid to well-differentiated sebaceous. Extraocular sebaceous carcinoma is an uncommon tumor. An occult primary at initial presentation has not been described previously. A 60-yr old woman was referred to the fine-needle aspiration (FNA) clinic with a submandibular mass. The cytological diagnosis was mucoepidermoid carcinoma. Histopathologically, it was a sebaceous carcinoma metastatic to the submandibular lymph node. No primary tumor was identified. Six months later, she presented with a nodule at the angle of her mouth and a recurrence of the submandibular swelling. FNA cytology (FNAC) and histopathologic examination revealed a primary cutaneous sebaceous carcinoma with submandibular lymph node metastasis. A metastatic sebaceous carcinoma in the submandibular region with limited sebaceous differentiation and occult primary is another pitfall in the cytomorphological diagnosis of mucoepidermoid carcinoma.

A Cytologic Perspective on Meibomian Gland Carcinoma

“…6 In the present study, this range of cytomorphologic findings led to misdiagnosis of the 3 cases of BCC as MGCA; however, BCC was the first differential diagnosis of these 3 cases, and 2 of them presented as a lower lid lesion, which is a common site for BCC. 1 On cytologic examination the lack of evident sebaceous differentiation in these 3 cases, together with the clinical presentation, indicated BCC as the differential diagnosis ( Figure 1E).…”

Cytologic Features of Primary Malignant Tumors of Skin and Adnexae

“…The ocular ones are also known as meibomian carcinomas. 18,19 This lesion is composed of lipid-containing cells that appear foamy and pale. Sudan IV staining confirms the presence of lipids in these foamy cells.…”

Fine Needle Aspiration Cytology in Diagnosis of Metastatic Sebaceous Gland Carcinoma of the Eyelid to the Lymph Nodes with Clinicopathological Correlation

“…The cytological diagnosis of SGC is based on the aspiration of tumor lobules with extensive sebaceous differentiation [7]. However, these tumors may show a spectrum of cells ranging from basaloid to well-differentiated sebaceous carcinoma, posing a difficulty in diagnosis of primary malignancy.…”