Sebaceous Carcinoma: A Review of the Scientific Literature

Abstract

Sebaceous carcinoma is a rare and potentially aggressive cutaneous malignancy. Commonly reported in the periocular area and the head and neck region, sebaceous carcinoma can arise from any sebaceous gland in the skin. The clinical presentation may be nonspecific, and a biopsy is important to establish a diagnosis and to differentiate from mimickers including benign sebaceous neoplasms, other adnexal tumors, and basal cell carcinoma. A diagnosis of Muir Torre syndrome should be considered in patients presenting with a sebaceous neoplasm. Early treatment is important given the potential of sebaceous carcinoma to spread to the regional lymph nodes and beyond. Sentinel lymph node biopsy and imaging to complete tumor staging may be indicated for larger or more aggressive tumors. Surgery, including Mohs micrographic surgery, remains the primary treatment modality for sebaceous carcinoma. Mohs micrographic surgery has the advantage of complete margin evaluation and low recurrence rates. Advanced cases may be treated with orbital exenteration, radiation therapy, chemotherapy, or combination therapy.

Impact of surgery and adjuvant treatment on the outcome of extraocular sebaceous carcinoma: a systematic review and individual patient's data analysis of 206 cases

“…This highlights aggressive nature of the disease once the disease spreads to the nodes and indicates necessity of aggressive workup including a CT scan or MRI for locoregional disease extension and nodal metastasis, although there is no standardized imaging modality in sebaceous carcinoma. 9,12 In addition, the analysis also found better OS and PFS for patients with a localized disease compared to those with metastatic disease. Although PET scan has not been evaluated for these diseases, a PET CT may be beneficial for diagnosing distant metastasis for patients with extensive locoregional disease.…”

“…The importance of regional nodal metastasis was elucidated as both median PFS and OS were significantly better for patients without regional nodal metastasis. This highlights aggressive nature of the disease once the disease spreads to the nodes and indicates necessity of aggressive workup including a CT scan or MRI for locoregional disease extension and nodal metastasis, although there is no standardized imaging modality in sebaceous carcinoma . In addition, the analysis also found better OS and PFS for patients with a localized disease compared to those with metastatic disease.…”

Detection of Epstein-Barr Virus in 130 Cases of Eyelid Sebaceous Gland Carcinoma Using In Situ Hybridization

“…Eyelid SGC is slow-growing but a highly invasive and malignant cancer of the eyelid [14]. is neoplasm always masquerades itself as chalazion, chronic conjunctivitis, or other tumors, resulting in delays in diagnosis and subsequent morbidity and mortality [15,16]. Studies have shown that EBV infection may be critical in the development of malignant tumors [17][18][19].…”

Nordic treatment practices survey and consensus for treatment of eyelid sebaceous carcinoma

“…According to Shields et al [13] chest x-ray, liver enzyme blood tests and work-up by MRI or CT are not necessary in small lesions. However, if there is a suspicion of orbital invasion or if the risk of nodal metastasis is high, T2b or more (AJCC 7-th edition), a orbital CT or MRI, thorax CT, parotid, submandibular and cervical lymph nodes ultrasonography or CT and possible fine needle aspiration biopsy are needed [8,13,18].…”

“…Muir-Torre syndrome (MTS) is a rare inherited condition characterized by a combination of sebaceous carcinoma, other sebaceous gland tumors and other malignant tumours; colorectal, genitourinary and breast cancer being the most common [1,8,9]. The opinions regarding screening for MTS vary, but it is suggested to rule out visceral malignancies as 6-20% of individuals with periocular sebaceous carcinoma develop visceral tumours [18,22]. In one series with eyelid sebaceous cancer, MTS was found in 1 of 34 patients [1], however, in another series, 10 of 31 patients had MTS as indicated by clinical diagnosis of visceral malignancies [23].…”