Recurrent sebaceous carcinoma of the scalp in a young male treated with adjuvant radiotherapy

Abstract

Sebaceous carcinoma is a rare malignancy of the skin appendages. It tends to occur in elderly patients. Orbital region is the most commonly involved site seen in 75% of cases. The involvement of extra-orbital sites is infrequent. Herein, a case of extra-ocular sebaceous carcinoma arising in the scalp of a 20-year-old man is described.The patient developed tumor relapse after excision biopsy. He was treated with wide local excision of the tumor. However, the patient developed local recurrence after an interval of four months for which he again underwent wide local excision. He did not manifest any regional or distant metastases. In view of the locally aggressive tumor, he received adjuvant radiation therapy. The patient was successfully treated with no evidence of any local recurrence seen after a follow-up period of one year. The timely recognition of sebaceous carcinoma is imperative so as to execute the primary treatment i.e., wide local excision. Adjuvant radiotherapy may be considered to improve the clinical outcome for recurrent tumors.

Management Considerations in Extraocular Sebaceous Carcinoma

“…More recently, external beam radiation therapy (XRT) has been used successfully as adjuvant therapy after surgical excision in extraocular SC with lymph node involvement, extensive local invasion, or for recurrent disease. 19,35,36,[47][48][49][50][51][52][53] Of note, the majority of reported cases lack crucial information, including margin status after excision and location of radiation site. See Table 1 for a summary of 15 reported extraocular SC cases using XRT.…”

Recurrent sebaceous carcinoma of the eyelid: Outcome after postoperative reirradiation

“…The primary tumor with the stage of T3a or greater has been significantly associated with local recurrence . The locally aggressive nature of sebaceous carcinoma has been reported . Supplemental cryotherapy or topical chemotherapy using mitomycin after the local excision has been used as a conservative treatment method in order to avoid orbital exenteration…”