Ten cases of sebaceous carcinoma arising in nevus sebaceus

Abstract

Although nevus sebaceus is known to develop various types of secondary neoplasms, it rarely causes carcinoma and only 14 cases of secondary sebaceous carcinoma have been reported. In this study, 10 cases of sebaceous carcinoma arising in nevus sebaceus were collected. The clinicopathological features and results of immunohistochemical examinations with adipophilin, perilipin and p53 were summarized. Sebaceous carcinoma arising in nevus sebaceous predominantly occurred on the scalp (8/10) of elderly women (mean age, 67.7 years). No case was associated with Muir-Torre syndrome. We found several pathological features of sebaceous carcinoma; that is, made up mainly of germinative cells, moderate nuclear atypia without pleomorphism and many mitoses (4-28/10 high-power field). Adipophilin and perilipin antibodies highlighted lipid drops in the cytoplasm of the malignant cells in all cases. Overexpression of p53 was seen in all cases. In two cases there were coexisting benign-looking sebaceous lesions at the periphery of the main cancer nodule, and in these lesions p53 showed low positivity compared with the clearly malignant area. There was co-occurrence of another neoplasm in three cases with trichoblastoma, sebaceoma and syringocystadenoma papilliferum, respectively. All cases were treated by excision of the malignant lesion, with or without inclusion of the nevus sebaceus. In a follow-up period of 1-7 years, there was no case of recurrence, lymph node metastases or distant metastases. With these specific pathological and immunohistochemical findings using adipophilin, perilipin and p53, we have to consider the possibility that there is a tendency to underdiagnose secondary sebaceous carcinomas in nevus sebaceus. These clinicopathological features of sebaceous carcinomas developing in the nevus sebaceus seem to indicate different biological entities from de novo sebaceous carcinoma.

Dermoscopic Analysis of Nevus Sebaceus of Jadassohn: A Study of 13 Cases

“…The clinical signs suggesting neoplastic transformation include rapid enlargement or development of a nodularity or an ulceration. Several different tumors of epidermal, adnexal, and mesenchymal origin are known to arise (one or more simultaneously [24,25,26]). Benign tumors [12,27,28,29,30,31,32] are the most common neoplasms, including syringocystadenoma papilliferum, apocrine cystadenoma, trichoblastoma, trichilemmal cysts, and keratoacanthoma.…”

Adipophilin expression in sebaceous tumors and other cutaneous lesions with clear cell histology: an immunohistochemical study of 117 cases

“…17 Additional studies have used these markers to confirm the lipid content in a variety of lesions from poorly differentiated sebaceous carcinomas arising in nevus sebaceus of Jadassohn to sebaceous epithelialmyoepithelial carcinomas of the salivary gland. [22][23][24] Other cutaneous lesions with clear cell histology may represent a differential diagnostic challenge with sebaceous lesions in routine hematoxylin and eosin staining, especially in the small biopsies of eyelid or periocular areas. 25 They include basal and squamous cell carcinomas that may have histologically focal or more diffuse clear cell differentiation.…”

Acantholytic Squamous Cell Carcinoma Arising in a Nevus Sebaceous : A Case Report

“…Tumors observed together included BCC with SCC, sebaceous carcinoma, or KA and SCC with adnexal carcinoma. (3,8,9,10) Our case is very rare variant of SCC (acantholytic) that has not been reported to date arising in nevus sebaceous.…”