Superficial epithelioma with sebaceous differentiation involving the eyelid: a case report

Abstract

IntroductionSuperficial epithelioma with sebaceous differentiation is a rare benign epithelial neoplasm. It usually involves the head, neck or the back of a middle-age person. To the best of our knowledge, two ocular cases have been reported in the literature.Case presentationA 46-year-old man of Italian descent, with a known history of testicular seminoma treated by orchiectomy with chemotherapy and radiotherapy, presented with a tan-colored lesion measuring 4mm in diameter in his right upper lid that had been growing over 10 months. It was clinically diagnosed as papilloma. An excisional biopsy was done. On histological examination, the lesion was a well-circumscribed and sharply demarcated epithelial tumor attached to the overlying epidermis and characterized by plate-like proliferation of basaloid to squamous cells with clusters of mature sebaceous cells and foci of ductal differentiation. After a follow-up period of 5 months, no recurrence of the lesion has been documented.ConclusionsSuperficial epithelioma with sebaceous differentiation is part of the differential diagnoses of eyelid lesions. Arguments in the literature about the correct nomenclature of superficial epithelioma with sebaceous differentiation have resulted in under-diagnosed cases. The benign histological features and the lack of recurrence support its benign nature. Although no clear association has linked superficial epithelioma with sebaceous differentiation with Muir–Torre syndrome, further clinical correlation and close follow up for patients are recommended.

Superficial epithelioma with sebaceous differentiation: a case report with literature review

“…Superficial epithelioma with sebaceous differentiation (SESD) is a rare histologically distinctive benign tumor, described for the first time in 1980 by Rothko et al as multiple lesions on a single patient (1). Since then, 20 more cases have been reported, most of them solitary lesions, mainly on the faces or backs of middleaged to elderly persons (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). The nomenclature of this tumor has been widely discussed, and the concept of reticulated acanthoma with sebaceous differentiation (RASD) was introduced by Steffen and Ackerman in 1993 in an effort to rename SESD (13).…”

Superficial Epithelioma with Sebaceous Differentiation Presented as a Yellow Plaque

“…In the literature, SESD has also been termed reticulated acanthoma with sebaceous differentiation2, seborrheic keratosis with sebaceous differentiation, and acanthomatous superficial sebaceous hamartoma3.…”

“…Superficial epithelioma with sebaceous differentiation (SESD) is a distinct, rare, benign neoplasm first described by Rothko et al 1 in 1980. In the literature, SESD has also been termed reticulated acanthoma with sebaceous differentiation 2 , seborrheic keratosis with sebaceous differentiation, and acanthomatous superficial sebaceous hamartoma 3 .…”

“…Histopathologically, SESD exhibits superficial plate-like proliferation of basaloid cells that are broadly attached to the overlying epidermis. Additional features include keratin-filled cysts, a well-formed ductal structure, and sebocytes of varying degrees of maturity presenting as single cells, cell clusters, and lobules 3 . The zones of sebaceous differentiation are located primarily at the lower poles of the lesions.…”

“…Accordingly, the authors suggested that SESD tumor cells differentiated toward sebofollicular epithelium rather than toward interfollicular epidermis 5 . Several reports have found that SESD and Muir-Torre syndrome (MTS) are not associated 1 2 3 . The fact that the nuclei of lesional cells stained uniformly for MSH-2 and MLH1, and the clinical history, support the lack of association of SESD and MTS in our present case.…”