Sebaceous Carcinomas: A Clinicopathological Comparison of Ocular and Extraocular Variants

Abstract

Sebaceous carcinomas (SC) are rare tumors and are currently classified into ocular and extraocular variants. Both variants of SC have very different clinical behavior and different histomorphologic appearance; however, published data are confounding as literature describes prognosis of both variants is similar or even that extraocular variants are more aggressive. In this study we evaluated the clinical and the histopathology of ocular and extraocular SC to confirm the difference between them. We performed a retrospective review of SC in which we studied the clinical and histomorphologic features of 106 cases, including 39 cases of ocular SC and 67 cases of extraocular SC. Only 2/67 cases of extraocular SC had multiple recurrences and none of them metastasized as opposed to our cases of ocular SC wherein 21/39 cases were locally aggressive with multiple recurrences and 5 cases metastasized. Histologically, both neoplasms showed major distinct morphologic features including poor differentiation in cases of ocular SC and well-differentiated tumors in the extraocular anatomic sites. To the best of our knowledge, this is the first case series of SC that compares the clinicopathologic features of ocular and extraocular variants. Awareness of such discrepancy is key to understand this disease and to possibly diagnose and manage these patients accordingly.

Sebaceous Carcinoma of the Submandibular Gland a Case Report and Review of the Literature

“…SCs can be categorized into well-differentiated and poorly-differentiated varieties based on the extent of sebocyte differentiation. 16 Poorly-differentiated lesions pose a challenge to pathologists as they lack any conspicuous sebocyte differentiation. Microscopic examination of the well-differentiated specimen showed that the sebocytes and duct epithelial cells formed many irregular, asymmetric sebaceous lobules.…”

Sebaceous Carcinoma of the Wrist in an Elderly Woman: A Case Report

“…Sebaceous carcinoma can be classified as ocular or extraocular depending on its tissue of origin, a distinction that is relevant in presentation, pathology, and treatment [ 1 , 2 ]. Up to 75% of cases of sebaceous carcinoma arise from the ocular adnexa, most often on the upper lid from the Meibominan glands of the tarsus or Zeis glands of the eyelashes [ 1 , 2 , 5 ]. Extraocular sebaceous carcinoma frequently arises from the skin of the head and neck, corresponding to the density of sebaceous glands [ 1 , 2 ].…”

“…Extraocular sebaceous carcinoma is more often associated with a better prognosis than ocular sebaceous carcinoma, although existing literature does include conflicting conclusions. Extraocular sebaceous carcinoma has a reduced tendency for metastasis to regional lymph nodes and reduced rates of recurrence relative to ocular sebaceous carcinoma [ 5 , 9 ]. Ocular sebaceous carcinomas can be assessed using the American Joint Committee on Cancer (AJCC) staging system, while extraocular sebaceous carcinomas can be assessed using the Union for International Cancer Control TNM staging system for skin carcinomas [ 3 ].…”