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Vempuluru VS, Sinha P, Tanna V, Maniktala Y, Palkonda VAR, Kaliki S. Neoadjuvant chemotherapy for advanced eyelid and periocular sebaceous gland carcinoma: a study of 25 cases. Int Ophthalmol 2024; 44:341. [PMID: 39103677 DOI: 10.1007/s10792-024-03256-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Accepted: 07/28/2024] [Indexed: 08/07/2024]
Abstract
PURPOSE To report the outcomes of platinum-based neoadjuvant chemotherapy (NACT) for eyelid and periocular sebaceous gland carcinoma (eSGC). METHODS Retrospective study of 25 patients. RESULTS The mean age at presentation of eSGC was 59 years. The mean tumor basal diameter was 46 mm. By the 8th edition of AJCC classification, tumors belonged T2 (n = 2, 8%), T3 (n = 6, 24%), and T4 (n = 17, 68%); N1 (n = 12,48%); and M1 (n = 1, 4%). NACT with 5-fluorouracil (5-FU) and cisplatin/carboplatin was administered in 21 (84%)/4 (16%) patients, respectively. The mean number of cycles of neoadjuvant systemic chemotherapy per patient was 2 (median, 3). The mean percentage reduction of tumor basal volume after neoadjuvant chemotherapy was 65% (median, 60%). After NACT, 12 (48%) patients underwent surgical treatment, 6 (12%) patients underwent EBRT, and 4 (8%) underwent adjuvant chemotherapy. A total of 11 (44%) patients were lost to follow-up during the course of treatment, of whom 3 died from metastatic disease. In 16 patients followed up for ≥ 3 months, complete tumor control was achieved in 11 (69%) patients, local tumor control in 14 (88%), and globe salvage in 7 (44%) at a mean follow-up of 25 months (median, 7 months; range, 3 to 110 months). No tumor recurrence was seen in any case. One (4%) serious adverse event of cardiotoxicity was noted. CONCLUSION Platinum-based NACT is a suitable option for eSGC with advanced tumors and locoregional metastasis. Adverse events are rare and in patients compliant with treatment, NACT-based combination therapy offers globe salvage and systemic tumor control.
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Affiliation(s)
- Vijitha S Vempuluru
- The Operation Eyesight Universal Institute for Eye Cancer, LV Prasad Eye Institute, L V Prasad Marg, Road No 2, Banjara Hills, Hyderabad, Telangana, 500034, India
| | - Prerna Sinha
- The Operation Eyesight Universal Institute for Eye Cancer, LV Prasad Eye Institute, L V Prasad Marg, Road No 2, Banjara Hills, Hyderabad, Telangana, 500034, India
| | - Vishakha Tanna
- The Operation Eyesight Universal Institute for Eye Cancer, LV Prasad Eye Institute, L V Prasad Marg, Road No 2, Banjara Hills, Hyderabad, Telangana, 500034, India
| | - Yamini Maniktala
- The Operation Eyesight Universal Institute for Eye Cancer, LV Prasad Eye Institute, L V Prasad Marg, Road No 2, Banjara Hills, Hyderabad, Telangana, 500034, India
| | - Vijay Anand Reddy Palkonda
- The Operation Eyesight Universal Institute for Eye Cancer, LV Prasad Eye Institute, L V Prasad Marg, Road No 2, Banjara Hills, Hyderabad, Telangana, 500034, India
| | - Swathi Kaliki
- The Operation Eyesight Universal Institute for Eye Cancer, LV Prasad Eye Institute, L V Prasad Marg, Road No 2, Banjara Hills, Hyderabad, Telangana, 500034, India.
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Yadlapati S, Rosa-Nieves PM, Mehta N, Merritt BG, Carrasquillo OY. Treatment of sebaceous carcinoma with Mohs micrographic surgery versus wide local excision: a systematic review. Int J Dermatol 2024. [PMID: 38856083 DOI: 10.1111/ijd.17283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 05/09/2024] [Accepted: 05/11/2024] [Indexed: 06/11/2024]
Abstract
Sebaceous carcinoma (SC) is a rare neoplasm affecting periocular and extraocular sites. If inadequately treated, it can recur and cause morbidity. Specific management guidelines have not been established. Wide local excision (WLE) has been traditionally used; however, Mohs micrographic surgery (MMS) can be advantageous because of complete margin assessment and tissue-sparing nature. This analysis aims to systematically review the surgical modalities used for the management of SC. Articles meeting eligibility criteria were identified using MEDLINE (via PubMed), Embase, Cochrane, and Scopus databases. All studies investigating surgical management of SC with WLE or MMS were considered. Seventy studies met inclusion criteria, including retrospective cohort studies, case series, and case reports. WLE was used in 32 studies, MMS in 29, and MMS and WLE in 9. Subgroup analysis showed that MMS has lower recurrence rates. For WLE, local, regional, and distant recurrence rates were 23.4%, 13.3%, and 11.0%, respectively, and for MMS, 6.8%, 4.3%, and 4.6%, respectively. Patients treated with WLE were more likely to have local recurrence than patients treated with MMS (P = 0.001). WLE cases were more likely to have a regional (P = 0.05) and distant recurrence (P = 0.001). Limitations of the study include heterogeneity of case reports, case series, and retrospective studies, variable follow-up times between the two groups, and large tumors included in the WLE category. In addition, disease-specific survival was not evaluated. MMS cases showed a superior outcome for local, regional, and distant recurrence, making it a good option for the management of SC.
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Affiliation(s)
- Sujitha Yadlapati
- HCA Corpus Christi Medical Center-Bay Area Dermatology Residency Program, McAllen, TX, USA
| | | | - Nina Mehta
- Department of Dermatology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Bradley G Merritt
- Department of Dermatology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Osward Y Carrasquillo
- Department of Dermatology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
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Kim S, Chaudhary PK, Upadhayaya S, Seo KW, Kim S. Histopathological and Immunohistochemical Characterization of Sebaceous Adenoma and Epithelioma in Dogs. Animals (Basel) 2024; 14:1457. [PMID: 38791674 PMCID: PMC11117200 DOI: 10.3390/ani14101457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 05/09/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024] Open
Abstract
Sebaceous gland tumors are neoplasms originating from the sebaceous gland and are the third most common type of skin tumor, accounting for 21-35% of all cutaneous neoplasms in dogs. According to their histopathological characteristics, sebaceous gland tumors can be classified into adenoma as a benign tumor and epithelioma as a malignant tumor. Sebaceous epithelioma is distinguished from sebaceous adenoma by containing 90% or more reserve cells. However, this simple numerical criterion is insufficient to histologically distinguish between epitheliomas and adenomas. In addition, sebaceoma in humans, a similar tumor to sebaceous epithelioma, is a term used for tumors with more than 50% of reserve cells, unlike epithelioma. Therefore, we aimed to compare and characterize the histological and immunohistochemical profiles of comprehensive sebaceous adenoma, epithelioma, and borderline tumors that have more than 50% but less than 90% of reserve cells. A total of 14 canine sebaceous tumors were diagnosed as seven adenomas, four borderline tumors, and three epitheliomas. Histologically, the sebaceous adenomas showed nodules consisting of mature sebocytes surrounded by monolayer basaloid cells. In contrast, the portion of the reserve cells was increased, the portion of lipidized cells was decreased, and the majority of lipidized cells were found to be immature in sebaceous epithelioma. In the sebaceous adenomas, necrosis was not observed and mitotic figures were rarely seen. However, necrosis and mitotic figures were highly frequent in both borderline tumor and sebaceous epithelioma. Immunohistochemistry revealed that borderline tumor and sebaceous epithelioma showed significantly higher expression against Ki-67 than sebaceous adenoma. We conclude that it is more accurate to employ the cut-off value of 50% reserve cells in humans rather than the current 90% reserve cells for classifying sebaceous gland tumors in dogs, thereby providing new insight into the characterization of the sebaceous gland tumors.
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Affiliation(s)
| | | | | | | | - Soochong Kim
- College of Veterinary Medicine, Chungbuk National University, Cheongju 28644, Republic of Korea; (S.K.); (P.K.C.); (S.U.); (K.W.S.)
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Wakefield C, Russell-Goldman E. Androgen Receptor Immunohistochemistry is Superior to PRAME for the Differentiation of Sebaceous Carcinoma From Primary Cutaneous Basaloid Mimics. Am J Dermatopathol 2024; 46:195-203. [PMID: 38488347 DOI: 10.1097/dad.0000000000002496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
ABSTRACT Cutaneous sebaceous neoplasia comprises a spectrum of disease ranging from benign adenomas to malignant carcinomas. The hallmark of these lesions is sebaceous differentiation. However, poorly-differentiated sebaceous carcinoma (SC), which lacks significant overt sebaceous differentiation, can show morphologic overlap with a variety of other basaloid cutaneous neoplasms. The accurate classification of SC is essential not only for diagnosis, but also because of the potential association with Muir-Torre syndrome. Androgen receptor (AR) is a sensitive, but not entirely specific immunohistochemical marker that has been used for the diagnosis of SC. PReferentially expressed Antigen in MElanoma (PRAME) demonstrates strong cytoplasmic labeling of mature sebocytes and has been reported to be expressed in a variety of sebaceous neoplasms, including in the basaloid cell component. Therefore, we sought to compare the diagnostic use of cytoplasmic PRAME expression with that of AR for the distinction of SC from a cohort of basaloid cutaneous mimics; namely basal cell carcinoma, basaloid squamous cell carcinoma, pilomatricoma, cutaneous lymphadenoma, and extra-mammary Paget disease. We report that cytoplasmic PRAME expression is uncommon in poorly differentiated SC, and although specific, it shows very low sensitivity (22%). In contrast, AR was moderately sensitive (66%) and highly specific (92%) for the distinction of SC from basaloid mimics. These attributes, in addition to the nuclear expression of AR in the sebocytic and basaloid components of SC, suggest that AR is superior to PRAME for the diagnosis of SC.
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Affiliation(s)
- Craig Wakefield
- Pathologists, Department of Pathology, Brigham and Women's Hospital, Boston, MA
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Salleh AA, Krishna Y, Coupland SE. Periocular Sebaceous Carcinoma: A Case Audit from the National Specialist Ophthalmic Pathology Service in Liverpool from 2009 to 2022 to Assess the Diagnostic Utility of PRAME Expression. Ocul Oncol Pathol 2024; 10:1-8. [PMID: 38645737 PMCID: PMC11024489 DOI: 10.1159/000535169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/08/2023] [Indexed: 04/23/2024] Open
Abstract
Introduction Periocular sebaceous carcinoma (PSC) remains a common diagnostic pitfall both clinically and histomorphologically. PRAME (preferentially expressed antigen in melanoma) has been studied in the various neoplasms as proposed as diagnostic and therapeutic markers. PRAME is expressed in normal sebaceous units and in some sebaceous lesions; however, its utility in sebaceous carcinoma diagnosis has not yet been extensively investigated. We conducted a 13-year retrospective review of the patients diagnosed with PSC at the National Specialist Ophthalmic Pathology Service in Liverpool. Herein, we report the histomorphological and immunohistochemical (IHC) features of these tumors, particularly PRAME expression in this cohort. Methods Thirty-one PSC cases diagnosed between 2009 and 2022 were retrieved from the histopathology archives. Twenty cases diagnosed as invasive PSC and 11 cases with in situ PSC were included. The hematoxylin and eosin (H&E) slides and previously performed IHC slides were reviewed; clinical information data were obtained. Cases with an adequate tissue were also stained for PRAME (preferentially expressed antigen in melanoma) and adipophilin (if not already performed). Results In total, there were 24 females and 7 males diagnosed with PSC, ranging from 55 to 90 years (median, 78 years). The types of specimens received were 11 conjunctival mapping biopsies, 19 excisions/wedge resections, and 1 orbital exenteration. The eyelid was the commonest site involved (n = 24), followed by eyelid with conjunctiva (3), and conjunctiva alone (4). All patients presented with the clinical suspicion of malignancy. Histologically, 11 invasive PSC (55%) exhibited poorly differentiated morphology, composed of predominantly atypical basaloid cells with minimal sebocytic differentiation; 9 cases (45%) were moderately differentiated with noticeable finely multivacuolated cytoplasm; and 3 (15%) showed associated comedo necrosis. Most invasive PSC showed moderate-to-brisk mitotic activities. Of those cases with available immunostains (n = 31), 25 (80.6%) expressed adipophilin; 18 (58.1%) Ber-EP4; 14 (45.2%) epithelial membrane antigen (EMA); and 5 (16.1%) both androgen receptor and perforin positivity. PRAME expression was seen in normal sebaceous glands; however, only (5/19; 26%) of invasive PSC showed focal weak-to-moderate PRAME positivity, and mostly in moderately differentiated tumors. None of the in situ PSCs were PRAME-positive. Conclusions Most PSCs are moderate-to-poorly differentiated. Although PRAME is expressed in normal sebaceous units, it appears less useful as diagnostic marker for PSC, especially in poorly differentiated tumors. In difficult cases, panels of IHC studies (adipophilin, Ber-EP4, and EMA) achieve a definitive diagnosis.
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Affiliation(s)
- Amizatul Aini Salleh
- Liverpool Ocular Oncology Research Group, Department of Molecular and Clinical Cancer Medicine, ISMIB, University of Liverpool, Liverpool, UK
- Liverpool Clinical Laboratories, Department of Cellular Pathology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
- Department of Pathology, Hospital Serdang, Serdang, Malaysia
| | - Yamini Krishna
- Liverpool Ocular Oncology Research Group, Department of Molecular and Clinical Cancer Medicine, ISMIB, University of Liverpool, Liverpool, UK
- Liverpool Clinical Laboratories, Department of Cellular Pathology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Sarah E. Coupland
- Liverpool Ocular Oncology Research Group, Department of Molecular and Clinical Cancer Medicine, ISMIB, University of Liverpool, Liverpool, UK
- Liverpool Clinical Laboratories, Department of Cellular Pathology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
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Olaofe OO, Adewara BA, Okongwu CC, Abdullahi YO. Sebaceous carcinoma in a 54-year-old Black African man after cancer chemotherapy: a case report. J Med Case Rep 2024; 18:159. [PMID: 38500211 PMCID: PMC10949574 DOI: 10.1186/s13256-024-04460-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 02/13/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Sebaceous carcinoma is a very rare malignant skin adnexal tumor that is occasionally aggressive. We have not seen a case of sebaceous carcinoma in our center in the last 10 years. It is extremely rare in Black Africans. CASE PRESENTATION We described the case of a 55-year-old man African man who presented to our ophthalmologist with complaints of growth on the right upper eyelid for 8 months. He had surgery and chemotherapy for rectal carcinoma 6 years prior to presentation and received his last dose of chemotherapy 5 years before seeing our ophthalmologist. There was a history of spontaneous unprovoked bleeding from the lesion. He subsequently underwent surgical excision under general anesthesia. Histology of the mass showed an effaced architecture due to proliferating malignant epithelial cells disposed as trabecules, solid nests, and tongues. The microscopic features of widespread multivacuolated cytoplasm of the neoplastic cells led us to conclude that the tumor was a sebaceous carcinoma. The patient is alive and well. CONCLUSION Sebaceous carcinoma is a rare malignant skin adnexal tumor in Black Africans. It can present as an eyelid mass with spontaneous bleeding. It can follow cancer chemotherapy either because of its association with other tumors in Muir-Torre syndrome or because of mutagenic effects of chemotherapeutic agents.
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Affiliation(s)
- Olaejirinde Olaniyi Olaofe
- Department of Morbid Anatomy and Forensic Medicine, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.
| | | | - Chigozie Chidozie Okongwu
- Department of Morbid Anatomy and Forensic Medicine, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
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Assiri SA, Altwairqi RG, Alotaibi R, Ibrahim M. External auditory canal sebaceous carcinoma. BMJ Case Rep 2023; 16:e255038. [PMID: 37775279 PMCID: PMC10546117 DOI: 10.1136/bcr-2023-255038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2023] [Indexed: 10/01/2023] Open
Abstract
The incidence of sebaceous carcinoma (SC) in the outer one-third of the external auditory canal is considered extremely rare, and only eight case reports have been published. We present a case of a male patient in his late 70s known case of hypertension on indapamide. His medical history included a postspinal tumour that had been treated with surgery and radiation more than 40 years ago and current complaints of right ear pain and purulent discharge. A right ear soft granular tissue mass was found. Complete debulking of the right ear mass was done in conjunction with middle ear exploration, moderately differentiated SC diagnosis was made based on the histopathological analysis. The patient was free of recurrence but then died of an unrelated pulmonary infection. SC should be suspected in elderly patients who present with long-term complaints of a mass with or without otalgia, and these patients should be examined for the presence of such tumours especially if they report a history of radiation. Additionally, more research is warranted to investigate the association of diuretics with SC.
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Affiliation(s)
- Sara A Assiri
- Otolaryngology-Head and Neck Surgery Department, King Faisal Medical Complex, Taif, Makkah, Saudi Arabia
| | - Rahaf Ghazi Altwairqi
- Otolaryngology-Head and Neck Surgery Department, Al Hada Military Hospital, Taif, Makkah, Saudi Arabia
| | | | - Mohammed Ibrahim
- Otorhinolaryngology-Head and Neck Surgery Department, Al Hada Military Hospital, Taif, Makkah, Saudi Arabia
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Xu W, Le Y, Zhang J. Prognostic risk factors and nomogram construction for sebaceous carcinoma: A population-based analysis. Front Oncol 2023; 13:981111. [PMID: 36923421 PMCID: PMC10009225 DOI: 10.3389/fonc.2023.981111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 02/15/2023] [Indexed: 03/03/2023] Open
Abstract
Background Sebaceous gland carcinoma (SGC) is a rare tumor for which there are currently no effective tools to predict patient outcomes. We analyzed the clinical and pathological prognostic risk factors of sebaceous carcinoma based on population data and created a nomogram of related risk factors, which can more accurately predict the 3-, 5-, and 10-year overall survival (OS) rates of patients. Methods SGC patients between 2004 and 2015 were collected from the Surveillance, Epidemiology, and End Results (SEER) database and randomly assigned to training and validation cohorts. Relevant risk factors were identified by univariate and multivariate COX hazards regression methods and combined to produce a correlation nomogram. The concordance index (C-index), the area under the receiver operating characteristic (AUC) curve, and calibration plots have demonstrated the predictive power of the nomogram. Decision curve analysis (DCA) was used to measure nomograms in clinical practice. Results A total of 2844 eligible patients were randomly assigned to 70% of the training group (n=1990) and 30% of the validation group (n=854) in this study. The derived meaningful prognostic factors were applied to the establishment of the nomogram. The C-index for OS was 0.725 (95% CI: 0.706-0.741) in the training cohort and 0.710 (95% CI: 0.683-0.737) in the validation cohort. The AUC and calibration plots of 3-, 5-, and 10-year OS rates showed that the nomogram had good predictive power. DCA demonstrated that the nomogram constructed in this study could provide a clinical net benefit. Conclusion We created a novel nomogram of prognostic factors for SGC, which more accurately and comprehensively predicted 3-, 5-, and 10-year OS in SGC patients. This can help clinicians identify high-risk patients as early as possible, carry out personalized treatment, follow-up, and monitoring, and improve the survival rate of SGC patients.
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Affiliation(s)
- Wen Xu
- Department of Dermatology, Peking University People's Hospital, Beijing, China
| | - Yijun Le
- Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing, China
| | - Jianzhong Zhang
- Department of Dermatology, Peking University People's Hospital, Beijing, China
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Wang F, Wang XY, Jiang X. Clinical Features and Prognosis of Young and Middle-Aged Adults With Skin Sebaceous Adenocarcinoma. Dermatol Surg 2022; 48:797-801. [PMID: 35917259 PMCID: PMC9371062 DOI: 10.1097/dss.0000000000003506] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sebaceous adenocarcinoma (SAC) mostly occurs in the elderly, and SAC in young and middle-aged population is inadequately investigated. OBJECTIVE To explore the clinical features and prognosis of young and middle-aged adults with SAC. MATERIALS AND METHODS Patients with skin SAC between ages 18 and 59 years from the Surveillance, Epidemiology, and End Results database (1975-2016) were eligible for this study. RESULTS Seven hundred thirty-nine cases were identified. The proportion of extraocular SAC in the nonelderly increased from 1975-2005 to 2006-2016 ( p = .001), male predominance was observed in overall patients whereas female predominance in Asian population, and young patients had more head and neck SAC than middle-aged patients ( p = .014). The prognosis of young patients was better than middle-aged patients ( p = .004). Other independent prognostic factors included sex, marital status, tumor size, surgery, chemotherapy, and multiple primary cancer history. CONCLUSION An increasing proportion of extraocular SAC was observed in young and middle-aged patients, and the young developed more head and neck SAC than the middle-aged. Female predominance was found in Asian population, and female patients had better prognosis. Younger age and married status indicated better prognosis, and around 20% of young and middle-aged patients might have poorer survival because of Muir-Torre syndrome.
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Affiliation(s)
- Fan Wang
- Department of Dermatology and Venerology, National Clinical Research Center for Geriatrics, Sichuan University West China Hospital, Chengdu, China;
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology (CIII), Frontiers Science Center for Disease-Related Molecular Network, Sichuan University West China Hospital, Chengdu, China;
| | - Xiu-Yun Wang
- Department of Abdominal Cancer, Sichuan University West China Hospital, Chengdu, China
| | - Xian Jiang
- Department of Dermatology and Venerology, National Clinical Research Center for Geriatrics, Sichuan University West China Hospital, Chengdu, China;
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology (CIII), Frontiers Science Center for Disease-Related Molecular Network, Sichuan University West China Hospital, Chengdu, China;
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Abstract
BACKGROUND There is a scarcity of information regarding the clinical characteristics of rare cutaneous malignancies in skin of color that has yet to be comprehensively explored. OBJECTIVE To review and compile the racial differences in epidemiology, clinical presentation, histology, treatments, and outcomes of 3 rare skin cancers: dermatofibrosarcoma protuberans (DFSP), Merkel cell carcinoma (MCC), and sebaceous carcinoma (SC). METHODS Several searches with keywords denoting specific skin cancer type and race were conducted on PubMed to complete this narrative review. RESULTS We analyzed 50 sources that were relevant to the initial objective. CONCLUSION The literature demonstrates that there are nuances in DFSP, MCC, and SC unique to African Americans, Asians/Pacific Islanders, and Hispanics that may differ significantly from Caucasian counterparts. African Americans consistently suffer from the worst clinical outcomes in all 3 rare cutaneous malignancies reviewed. Greater physician awareness and knowledge of the discussed racial differences is the preliminary step to address these disparities.
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Affiliation(s)
- Daniel Mosallaei
- Department of Dermatology, University of Southern California, Los Angeles, California
| | - Erica B Lee
- Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Marissa Lobl
- Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Dillon Clarey
- Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Ashley Wysong
- Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska
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Cheng AY, Lan J, Lee CH. Impaired Wnt/beta-catenin and protein patched homolog 1 signaling in extraocular sebaceous carcinoma: A clinical and histopathological study. J Dermatol 2022; 49:600-606. [PMID: 35318716 DOI: 10.1111/1346-8138.16351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/07/2022] [Accepted: 02/22/2022] [Indexed: 11/29/2022]
Abstract
Sebaceous carcinoma (SC) is a rare malignant neoplasm with sebaceous differentiation. SC is classified into eyelid and extraocular SC clinically. Most studies have focused on the eyelid SC in terms of pathogenesis, treatment, and prognosis. In skin, Wnt/beta-catenin and hedgehog signaling are two major pathways in sebaceous differentiation. We aimed to characterize the clinical and histopathological features of extraocular SC and to measure the expression of beta-catenin, lymphoid enhancer-binding factor 1 (LEF1), sonic hedgehog (Shh), and protein patched homolog 1 (PTCH) in extraocular SC. Ten cases of extraocular SC were identified from 2007 to 2020. The clinical features, microscopic findings, and prognosis were analyzed. Immunohistochemical stain for beta-catenin, LEF1, Shh, and PTCH were performed in extraocular SC and other benign sebaceous tumors including sebaceous hyperplasia, sebaceous adenoma, and sebaceoma. The male:female ratio was 4:6. The median onset age was 73.5 years (range, 43-88). Seven patients out of 10 were diagnosed after 60 years. Most extraocular SC were located on the head and neck with indurated plaque. Two patients had concurrent internal cancers and three patients showed lymph node metastasis at time of presentation. Five-year overall-survival was 40%. Beta-catenin was expressed membranously in all sebaceous hyperplasia, but was expressed variably in extraocular SC (1/5). While LEF1 was unequivocally expressed in normal hair follicles, LEF1 expression was absent in all extraocular SC and benign sebaceous tumors. Regarding the sonic hedgehog signaling, Shh and PTCH were all expressed in the cytoplasm of sebaceous hyperplasia, sebaceous adenoma, and sebaceoma. In contrast, PTCH was absent in all cases of extraocular SC and only 50% of the extraocular SC expressed cytoplasmic Shh. To conclude, extraocular SC commonly affects facial skin in the elderly. Inactivated Wnt/beta-catenin and aberrant hedgehog pathway may contribute to the carcinogenesis of extraocular SC. Further studies may be required to elucidate the causative mechanism of these pathways in extraocular SC.
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Affiliation(s)
- An-Yu Cheng
- Department of Dermatology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Jui Lan
- Department of Anatomic Pathology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chih-Hung Lee
- Department of Dermatology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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12
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Alam MS, Banerjee P, Krishnakumar S. The effect of direct cell injury inflicted by cryotherapy on eyelid sebaceous gland carcinoma cells: An ex-vivo experimental study. Indian J Ophthalmol 2022; 70:630-633. [PMID: 35086251 PMCID: PMC9023907 DOI: 10.4103/ijo.ijo_1814_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose: To evaluate the effect of direct cell injury of cryotherapy on eyelid sebaceous gland carcinoma cells by an ex vivo cryotherapy experiment. Methods: It was a prospective interventional case series. Six patients with biopsy-proven nodular sebaceous gland carcinoma were included. After excision of the mass, a thin slice of the mass resembling the thickness of the conjunctiva was shaved off and was oriented over the broad end of a tissue forceps. Cryotherapy was applied to both its anterior and posterior aspects by the triple freeze-thaw technique. The mass was then labeled and sent separately for histopathological evaluation by fixation and staining. Results: A total of six patients with a mean age of 58.2 ± 15.5 years were included. There were four females and two males. The mean duration of the lesion was 21.6 ± 17.51 months. All patients had involvement of the upper eyelid. The patients were clinically staged as T2b (n=2), T1a (n=2), T2c (n=1), and T3a (n=1) respectively. There was no regional lymphadenopathy or metastasis in any of the cases. The experimental cryo-tissue containing the cryo-treated lesion revealed the presence of viable tumor cells (>50%) in all six specimens. Conclusion: The direct cell injury caused by cryotherapy may not be sufficient to kill all the residual sebaceous gland carcinoma cells on the tumor bed.
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Affiliation(s)
- Md Shahid Alam
- Orbit, Oculoplasty, Reconstructive and Aesthetic Services, Aditya Birla Sankara Nethralaya (A Unit of Medical Research Foundation, Chennai, India), Kolkata, West Bengal, India
| | - Prabrisha Banerjee
- Orbit, Oculoplasty, Reconstructive and Aesthetic Services, Aditya Birla Sankara Nethralaya (A Unit of Medical Research Foundation, Chennai, India) Kolkata, West Bengal, India
| | - Subramanian Krishnakumar
- Larson and Turbo Department of Ocular Pathology, Vision Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
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13
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Mercuţ R, Ionescu M, Simionescu C, Pîrvănescu V, Mercuţ MF, Gogănău A, Ciurea ME. Left Buttock Sebaceus Carcinoma: A Case Report and Review of the Literature. CURRENT HEALTH SCIENCES JOURNAL 2021; 47:595-601. [PMID: 35444817 PMCID: PMC8987477 DOI: 10.12865/chsj.47.04.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 12/15/2021] [Indexed: 11/18/2022]
Abstract
Sebaceous carcinoma is a rare, aggressive, malignant tumour, characterized by a tendency for local recurrence and distant metastases. This case report presents a rare form of sebaceous carcinoma in an 86 years-old female. Clinical examination revealed a 12cm nodular tumour, yellow-brown in colour, located on the left buttock of the patient. Ultrasound examination indicated that no ganglions were affected; dermatological examination suggested that the tumour had an unpredictable evolution. Treatment was surgical with a 2cm wide excision, followed by reconstruction with a VY skin flap, from the left side of the buttock. Histological exam supported the diagnosis of sebaceous carcinoma; the tumour was removed with a safety margin of healthy tissue. Sebaceous carcinoma is a malignant tumour with unpredictable evolution. Diagnosis is based on histological examination. Treatment of choice consists in complete wide surgical excision.
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Affiliation(s)
- Răzvan Mercuţ
- Department of Plastic and Reconstructive Surgery, University of Medicine and Pharmacy of Craiova, Romania
| | - Mihaela Ionescu
- Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy of Craiova, Romania
| | - Cristiana Simionescu
- Department of Pathology, University of Medicine and Pharmacy of Craiova, Romania
| | - Vlad Pîrvănescu
- Department of Plastic and Reconstructive Surgery, University of Medicine and Pharmacy of Craiova, Romania
| | - Maria Filoftea Mercuţ
- Department of Ophthalmology, University of Medicine and Pharmacy of Craiova, Romania
| | - Alexandru Gogănău
- Department of General Surgery, University of Medicine and Pharmacy of Craiova, Romania
| | - Marius Eugen Ciurea
- Department of Plastic and Reconstructive Surgery, University of Medicine and Pharmacy of Craiova, Romania
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14
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Boecker W, Reusch M, Mielke V, Reusch U, Hallermann C, Loening T, Tiemann M, Buchwalow I. Twenty-Eight Cases of Extraocular Sebaceous Carcinoma: A Correlative Clinicopathological and Immunohistochemical Analysis of Extraocular Sebaceous Carcinomas and Benign Sebaceous Gland Tumors. Am J Dermatopathol 2021; 43:93-102. [PMID: 32568835 DOI: 10.1097/dad.0000000000001667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
ABSTRACT Extraocular sebaceous carcinoma (ESC) is a rare appendiceal skin tumor. In contrast to ocular sebaceous carcinoma, information about the exact cellular architecture of these lesions is scarce and the histogenesis of ESC is unknown. Here, we extend our previous study and investigate 28 extraocular carcinomas in comparison to 54 benign sebaceous tumors and 8 cases of normal sebaceous glands using a broad spectrum of antibodies against p63, several keratins, adipophilin, EMA, Ki67, androgen receptor, and mismatch repair proteins. This observational study demonstrates that p63- and K5/14-positive basaloid cells are key cells in normal sebaceous gland and in all sebaceous tumors and that these basaloid cells give rise to EMA+, adipophilin+ sebocytes, and K5/14+, K7±, K10± ductal structures. Finally, about half of ESC is associated with superficial in situ neoplasia, which provides evidence that at least part of these carcinomas arises from flat superficial in situ carcinoma. In contrast to the normal sebaceous gland, about half of all sebaceous tumors lack keratin K7. MMR protein IHC-profiles role will be discussed.
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Affiliation(s)
- Werner Boecker
- Gerhard-Domagk-Institute of Pathology, University of Muenster, Münster, Germany
- Dermatopathology Laboratory, Hamburg, Germany
- Gerhard-Seifert Referenzzentrum, Hamburg, Germany; and
| | | | | | | | | | | | | | - Igor Buchwalow
- Gerhard-Domagk-Institute of Pathology, University of Muenster, Münster, Germany
- Institute for Hematopathology, Hamburg, Germany
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15
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Desiato VM, Byun YJ, Nguyen SA, Thiers BH, Day TA. Sebaceous Carcinoma of the Eyelid: A Systematic Review and Meta-Analysis. Dermatol Surg 2021; 47:104-110. [PMID: 33347004 DOI: 10.1097/dss.0000000000002660] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sebaceous carcinoma (SC) of the eyelid is a rare, aggressive malignancy associated with high rates of recurrence, metastasis, and tumor-related mortality. OBJECTIVE Provide a collective analysis of clinical presentations, management techniques, and outcomes, and compare outcomes of common treatment methods. METHODS AND MATERIALS Observational studies reporting management and outcomes of SC of the eyelid were included. Patient and clinical data were extracted, and meta-analysis of proportions was performed. RESULTS One thousand three hundred thirty-three subjects were included with a mean age of 65.2 years and 803 (60.2%) women. Of 647 initial diagnoses reported, 277 (42.8%) were correct, and the mean diagnostic delay was 14.7 months (range 8.5-34.8). The tumor location was reported in 1,246 subjects and involved the upper eyelid in 780 (62.6%), lower eyelid in 409 (32.8%), and 57 (4.8%) involved both. Overall rates of recurrence, metastasis, and tumor-related mortality were 15.9%, 12.1%, and 6.2%, respectively. There were no statistically significant differences in wide local excision (WLE) versus Mohs micrographic surgery (MMS) outcomes. CONCLUSION Sebaceous carcinoma of the eyelid is more common in women, on the upper eyelid, and is frequently misdiagnosed initially. Rate of recurrence, metastasis, and tumor-related mortality were similar in subjects managed with WLE versus MMS.
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Affiliation(s)
- Vincent M Desiato
- Department of Otolaryngology, Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Young Jae Byun
- Department of Otolaryngology, Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
- University of Central Florida College of Medicine, Orlando, Florida
| | - Shaun A Nguyen
- Department of Otolaryngology, Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Bruce H Thiers
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Terry A Day
- Department of Otolaryngology, Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
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16
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Siguan APT, Yray MDS. Sebaceous carcinoma of the axilla. J Surg Case Rep 2020; 2020:rjaa513. [PMID: 33391643 PMCID: PMC7765709 DOI: 10.1093/jscr/rjaa513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/04/2020] [Accepted: 11/13/2020] [Indexed: 11/12/2022] Open
Abstract
Sebaceous carcinoma is a rare cutaneous malignant neoplasm with an estimated incidence rate of approximately 1–2 per 1 000 000 per year. It rarely presents as an extra-ocular type and it affects patients in between the sixth and eighth decades of life. This is a case of a 31-year-old male with a 10-year history of a right axillary mass with an incisional biopsy of a sebaceous carcinoma. The mass was 10 × 6 cm in largest diameter, erythematous, non-tender and irregularly shaped. The patient underwent wide excision of the right axillary mass with negative margins confirmed by frozen section under general anesthesia. A parascapular fasciocutaneous flap was done in order to provide coverage for the defect. The patient was then discharged improved on the fourth postoperative day. Although there has been no established clinical protocol for the staging, medical and surgical management for extra-ocular sebaceous carcinoma, early diagnosis accompanied with the proper surgical intervention, such as oncologic wide excision with negative margins, were both adequate and paramount to the diagnosis, course and treatment of this patient, given its rarity.
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Affiliation(s)
- Anthony Paolo T Siguan
- Department of General Surgery, Vicente Sotto Memorial Medical Center, Cebu City, Philippines
| | - Marc Denver S Yray
- Department of General Surgery, Vicente Sotto Memorial Medical Center, Cebu City, Philippines
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17
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AlHammad F, Edward DP, Alkatan HM, Elkhamary S, Iuliano A, Maktabi A, Al-Horani SED, Al-Sheikh O, Al Hussain H, Strianese D. Eyelid sebaceous gland carcinoma: An assessment of the T classification of the American Joint Committee of Cancer TNM staging system 8th versus 7th edition. Eur J Ophthalmol 2020; 31:2055-2063. [PMID: 32567368 DOI: 10.1177/1120672120936488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To assess the prognostic values of the T classification of the 8th edition of the American Joint Committee of Cancer staging system and compare it to the 7th edition. METHODS Multicenter retrospective study of patients with eyelid sebaceous gland carcinoma. The primary outcome measure was the differences between outcomes when tumors were staged with either 7th or 8th edition. The measures evaluated included presenting features, management, histopathology, metastasis, recurrence, and mortality. RESULTS Of the 60 patients (median age 73 years), 31 (51.7%) were females. A change in T staging occurred in 39 patients (65%) when the 8th edition was applied. Advanced categories (T3/T4) were significantly associated with nodal metastasis (p = 0.037) using the 8th edition criteria but not with the 7th edition (p = 0.066). The 8th edition T categorization significantly correlated with eye survival (p = 0.022) while the 7th edition did not (p = 0.058). Applying the 8th edition, category T4 at presentation was associated with a higher risk of nodal metastasis (p = 0.037) but not associated with local recurrence, distant metastasis, or tumor-related death (p = 0.281, p = 0.737, p = 0.319, respectively). T3/T4 category tumors were significantly associated with poor tumor differentiation (p = 0.001), and papillary histologic pattern (p = 0.024) but not with pagetoid spread (p = 0.056). CONCLUSION The application of the 8th edition AJCC staging system for eyelid SGC may accurately predict nodal metastasis. Local recurrence and distant metastasis were not significantly associated with T classification, using either edition. Poor tumor differentiation and papillary pattern were associated with T3/T4 categories suggesting that pathological features may assist in determining prognosis.
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Affiliation(s)
- Fatimah AlHammad
- King Khaled Eye Specialist Hospital- KKESH- Riyadh, Saudi Arabia.,Dhahran Eye Specialist Hospital, Dhahran, Saudi Arabia
| | - Deepak P Edward
- King Khaled Eye Specialist Hospital- KKESH- Riyadh, Saudi Arabia.,Department of Ophthalmology and Visual Science, University of Illinois College of Medicine, Chicago, IL, USA
| | - Hind M Alkatan
- Departments of Ophthalmology and Pathology, King Saud University, College of Medicine, Riyadh, Saudi Arabia
| | - Sahar Elkhamary
- King Khaled Eye Specialist Hospital- KKESH- Riyadh, Saudi Arabia
| | - Adriana Iuliano
- Department of Neuroscience, Reproductive Sciences and Dentistry- University of Naples "Federico II," School of Medicine, Naples, Italy
| | - Azza Maktabi
- King Khaled Eye Specialist Hospital- KKESH- Riyadh, Saudi Arabia
| | | | - Osama Al-Sheikh
- King Khaled Eye Specialist Hospital- KKESH- Riyadh, Saudi Arabia
| | | | - Diego Strianese
- King Khaled Eye Specialist Hospital- KKESH- Riyadh, Saudi Arabia.,Department of Neuroscience, Reproductive Sciences and Dentistry- University of Naples "Federico II," School of Medicine, Naples, Italy
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18
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Cheng CY, Su HJ, Kuo TT. Dermoscopic features and differential diagnosis of sebaceous carcinoma. J Dermatol 2020; 47:755-762. [PMID: 32415798 DOI: 10.1111/1346-8138.15384] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 04/13/2020] [Indexed: 11/28/2022]
Abstract
Sebaceous carcinoma is a rare malignant skin neoplasm arising from sebaceous glands. Its clinical diagnosis is difficult and reports of dermoscopic findings have been limited. This study aims to analyze its dermoscopic features and differential diagnosis in dermoscopic examination. The study included patients diagnosed with histologically proven sebaceous carcinomas as well as diagnosed cases of sebaceous hyperplasia, sebaceoma, squamous cell carcinoma and basal cell carcinoma for comparison of dermoscopic findings. The dermoscopic criterion of presence of sebaceous carcinoma was scored only if the two evaluators reached a consensus. Fifteen cases of histologically diagnosed sebaceous carcinoma were included in our study. All cases were extraocular sebaceous carcinoma. A total of 60 (15 basal cell carcinomas, 15 squamous cell carcinomas, 15 sebaceous hyperplasias and 15 sebaceomas) cases were collected for comparing dermoscopic features with sebaceous carcinoma. In dermoscopic analysis of sebaceous carcinoma, the majority of tumors (66.67%) presented polymorphic vessel pattern. Other features included whitish-pink areas (80%), yellowish structures (73.33%) and yellowish structureless areas (60%). Yellowish structures in sebaceous carcinomas are the main dermoscopic findings to differentiate squamous cell and basal cell carcinomas (P < 0.001), whereas purplish globules, shiny white blotches and strands and whitish-pink area distinguish sebaceous carcinomas from other sebaceous tumors (P < 0.05).
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Affiliation(s)
- Chun-Yu Cheng
- Department of Dermatology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan.,Department of Cosmetic Science, Chang Gung University of Science and Technology, Taoyuan, Taiwan.,Center of Tissue Engineering, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Hsing-Jou Su
- Department of Dermatology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Tseng-Tong Kuo
- Department of Pathology, Chang Gung Memorial Hospital, Taipei, Taiwan
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19
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Dika E, Patrizi A, Veronesi G, Manuelpillai N, Lambertini M. Malignant cutaneous tumours of the scalp: always remember to examine the head. J Eur Acad Dermatol Venereol 2020; 34:2208-2215. [DOI: 10.1111/jdv.16330] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 02/18/2020] [Indexed: 12/15/2022]
Affiliation(s)
- E. Dika
- Dermatology Department of Experimental, Diagnostic and Specialty Medicine University of Bologna Bologna Italy
| | - A. Patrizi
- Dermatology Department of Experimental, Diagnostic and Specialty Medicine University of Bologna Bologna Italy
| | - G. Veronesi
- Dermatology Department of Experimental, Diagnostic and Specialty Medicine University of Bologna Bologna Italy
| | - N. Manuelpillai
- Dermatology Department of Experimental, Diagnostic and Specialty Medicine University of Bologna Bologna Italy
| | - M. Lambertini
- Dermatology Department of Experimental, Diagnostic and Specialty Medicine University of Bologna Bologna Italy
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20
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Kholaki O, Chang D, Kim RY. Nasal Sebaceous Carcinoma: A Case Report and Review of the Literature. J Oral Maxillofac Surg 2019; 78:82-86. [PMID: 31526773 DOI: 10.1016/j.joms.2019.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 08/12/2019] [Accepted: 08/13/2019] [Indexed: 11/28/2022]
Abstract
Sebaceous carcinoma arising from the nasal vestibule is exceedingly rare, with 3 cases previously reported. We have described the case of a 69-year-old man with an indolent exophytic growth on the medial aspect of his right nasal vestibule. Incisional biopsy demonstrated sebaceous carcinoma. The clinical and pathologic features, in addition to the surgical course and the postoperative outcome, are discussed. We also report our findings from a review of the reported data, focusing on the diagnosis and treatment of this rare skin malignancy.
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Affiliation(s)
- Omar Kholaki
- Resident Surgeon, Department of Oral and Maxillofacial Surgery, Parkland/University of Texas Southwestern Medical Center, Dallas, TX.
| | - Dongkun Chang
- Pathologist, John Peter Smith Health Network, Fort Worth, TX
| | - Roderick Y Kim
- Assistant Fellowship Director and Director of Research, Division of Maxillofacial Oncology and Reconstructive Surgery, Department of Oral and Maxillofacial Surgery, John Peter Smith Health Network, Fort Worth, TX
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21
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Lee IJ, Koh JY. Impact of clinicopathologic factors on survival in patients with sebaceous carcinoma of the eyelid - a population-based analysis. Orbit 2019; 38:261-268. [PMID: 30373440 DOI: 10.1080/01676830.2018.1505922] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 07/22/2018] [Indexed: 06/08/2023]
Abstract
Purpose: To evaluate prognostic factors and survival of patients with sebaceous carcinoma of the eyelid through a population-based analysis. Methods: A total of 940 patients with primary sebaceous carcinoma of the eyelid were derived from the Surveillance, Epidemiology, and End Results (SEER) database in the United States from 1973 to 2013. Kaplan-Meier univariate analysis and Cox Regression multivariate analysis were performed to examine prognostic factors in overall survival (OS). 5- and 10-year survival rates, median survival, and prognostic variables with statistical significance were measured. Results: Kaplan-Meier analysis showed that OS is 66% and 44% at 5 years and 10 years respectively. Median OS is 9.4 years. Multivariate Cox regression analysis demonstrated that independent prognostic factors for OS are age at diagnosis (HR = 4.61 [95% CI 1.93-11.0], P = 0.001), surgical treatment (HR = 0.196 [95% CI 0.07-0.55], P = 0.002), combined surgical and radiation treatment (HR = 0.227 [95% CI 0.06-0.81], P = 0.023), and greater tumor size at diagnosis (HR = 3.381, [95% CI 1.77-6.45], P < 0.001). Conclusion: We report the largest population study to date to evaluate prognostic factors of patients with sebaceous carcinoma of the eyelid. Multivariate analysis shows that older age, and greater tumor size correlate with decreased overall survival, whereas surgical treatment or combined surgical and radiation treatment correlate with increased overall survival. Interestingly, tumor grade, lymph node involvement, and distant extent of tumor have not demonstrated to be independent prognostic factors for overall survival.
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Affiliation(s)
- Ivan J Lee
- a Department of Ophthalmology, Oakland University William Beaumont School of Medicine , Royal Oak , MI , USA
| | - John Y Koh
- a Department of Ophthalmology, Oakland University William Beaumont School of Medicine , Royal Oak , MI , USA
- b Department of Ophthalmology, Wayne State University School of Medicine , Detroit , MI , USA
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22
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Kim JE, Kim JH, Chung KY, Yoon JS, Roh MR. Clinical Features and Association with Visceral Malignancy in 80 Patients with Sebaceous Neoplasms. Ann Dermatol 2019; 31:14-21. [PMID: 33911534 PMCID: PMC7992712 DOI: 10.5021/ad.2019.31.1.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 07/25/2018] [Accepted: 07/27/2018] [Indexed: 11/12/2022] Open
Abstract
Background Sebaceous neoplasm is a rare subgroup of appendageal tumors that differentiate towards sebaceous adnexal structures of the skin and are known to be associated with visceral malignancy. Objective We aimed to analyze and compare the clinical data including the past history of associated visceral malignancy in patients with sebaceous carcinoma (SC) and benign sebaceous neoplasms (BSN), such as sebaceous adenomas and sebaceomas. Methods We retrospectively reviewed the cases of consecutive patients diagnosed with sebaceous neoplasms. Basic demographic data, past medical history, and clinical data regarding the size, location, and presence of associated visceral malignancies were evaluated. Results A total of 80 patients of sebaceous neoplasms (51 SC, 29 BSN) were included. A total of 18 associated visceral malignancies were found in 14 patients (8 SC, 6 BSN). Two patients were diagnosed with subsequent visceral malignancies during the primary work-up process for sebaceous neoplasms. The mean age at diagnosis of the visceral malignancies was 63.9 and 47.5 years for patients with SC and BSN, respectively. The most common site of visceral malignancies was the gastrointestinal (GI) tract. Adenocarcinoma was the most common histologic type of the visceral malignancy noted. Conclusion We observed associated visceral malignancies in 15.7% of patients with SC and 20.7% with BSN. Our results suggest a need for screening of visceral malignancies, especially of the GI tract, in patients with sebaceous neoplasms.
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Affiliation(s)
- Jee Eun Kim
- Department of Dermatology, Gangnam Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Hoon Kim
- Department of Dermatology, Gangnam Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Kee-Yang Chung
- Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jin Sook Yoon
- Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
| | - Mi Ryung Roh
- Department of Dermatology, Gangnam Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
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23
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Cicinelli MV, Kaliki S. Ocular sebaceous gland carcinoma: an update of the literature. Int Ophthalmol 2018; 39:1187-1197. [DOI: 10.1007/s10792-018-0925-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Accepted: 04/13/2018] [Indexed: 02/07/2023]
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