Sebaceous carcinoma of trunk with bilateral axillary lymph node metastasis: a rare presentation of malignant adnexal tumor in young adult

Abstract

Malignant adnexal tumors of skin are rare. Sebaceous carcinoma—a rare and aggressive cutaneous tumor—is frequently located in the periorbital region. Malignant adnexal tumors of sebaceous carcinoma type on trunk with axillary lymph node and distant metastasis in young adult is rare. The incidence of extraocular sebaceous carcinoma has been expected to be 0.06 per 100 000 person-years with an increased incidence in elderly patients and men. With a note of mimicking benign dermatologic conditions, definitive diagnosis of sebaceous carcinomas is often hindered, increasing morbidity and mortality for patients. Herein, we present a case of a 35-year-old man with a large ulcero-proliferating lesion of trunk region previously resected for a small swelling and eventually presented with the recurrent lesion and diagnosed as sebaceous carcinoma of trunk with bilateral axillary lymphnode and distant bone metastasis demonstrating several diagnostic and management challenges.

A Rare Case of a Giant Tumor of Sebaceous Glands in the Posterior Chest Wall

“…In a retrospective study in the Surveillance, Epidemiology and End Results (SEER) database conducted in the USA from 1988 to 2006, with 4032 MATS, only 16.8% were identified in the trunk and only 7.4% exhibited lymph node metastases [4]. This same study shows that the incidence of extraocular sebaceous carcinoma was 0.06/100,000 people per year, with a tendency to increase in the elderly and in men [4].…”

“…About 25% of its cases are extraocular and are generally located on the head and neck, although references are pointing that the following are also possible locations for the disease: parotid, breast, ovary, prostate, trunk, and extremities [2,4,7,9,12,14].…”

“…Extraocular sebaceous carcinoma, in addition to presenting local recurrence between 9% and 36% of cases in the 5-year period, can also cause regional metastasis through lymph node involvement in 28% of cases and at a distance compromising the liver, lung, bones, brain and urinary tract in 21% of cases. The 5-year survival reaches 68% of cases [2][3][4]7].…”

“…Sebaceous carcinoma is a rare and aggressive skin cancer that originates from the adnexal epithelium of the sebaceous gland and corresponds to 0.2% to 4.6% of all cutaneous malignant tumors [1][2][3][4][5][6]. Although it can be found in any part of the body that has sebaceous glands, the periorbital region is the most affected (75%) [1,4,5,7].…”

“…Extraocular sebaceous carcinoma accounts for only 25% of cases and may affect the head, neck, external genitalia, extremities and trunk [1,4,[7][8][9]. Without specific symptoms, the diagnosis is restricted to the immunohistochemical analysis, with the use of several markers, after biopsy or total resection of the lesion [1][2][3]5].…”