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Silva Cunha JL, Paes de Almeida O, de Carvalho MGF, Dantas Soares C. Intraoral sebaceous carcinoma: A rare presentation on the tongue and review of the literature. Oral Oncol 2024; 148:106647. [PMID: 38006687 DOI: 10.1016/j.oraloncology.2023.106647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 11/12/2023] [Accepted: 11/20/2023] [Indexed: 11/27/2023]
Abstract
Intraoral sebaceous carcinoma (SC) is exceedingly rare, especially in the tongue. We reported the clinicopathological and immunohistochemical features of a rare SC case in a 59-year-old male who presented a painful ulcer on the tongue's posterior region. Microscopically, the tumor was composed of atypical basaloid cells with round to oval nuclei and prominent nucleoli arranged in lobes showing prominent sebaceous differentiation and areas of holocrine secretion. Immunohistochemistry showed positivity for pan-cytokeratin AE1/AE3 and epithelial membrane antigen (EMA) and negativity for cytokeratin 7 (CK7). The sebaceous cells were positive for adipophilin and perforin. Wide surgical excision followed by adjuvant chemotherapy and radiotherapy was performed. Careful histopathological analysis of these lesions is crucial to ensure a correct diagnosis. Due to the aggressive behavior of SCs, early diagnosis and treatment are essential to increase the patient's survival time. To the best of our knowledge, this is the second case of SC in the tongue.
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Affiliation(s)
- John Lennon Silva Cunha
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil.
| | - Oslei Paes de Almeida
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil.
| | | | - Ciro Dantas Soares
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil; Private Pathology Service, Natal, RN, Brazil.
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Dowell-Esquivel C, Lee R, DiCaprio RC, Nouri K. Sebaceous carcinoma: an updated review of pathogenesis, diagnosis, and treatment options. Arch Dermatol Res 2023; 316:55. [PMID: 38112896 DOI: 10.1007/s00403-023-02747-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 10/10/2023] [Accepted: 10/26/2023] [Indexed: 12/21/2023]
Abstract
Sebaceous carcinoma (SC) is a very rare and aggressive form of skin cancer that arises from the sebaceous glands. SC can occur anywhere on the body, but most commonly affects the head and neck, especially the upper eyelid. SC is the third most common malignancy of the eyelid and has the potential to metastasize and be fatal; therefore, it is vital for dermatologists to remain acquainted with this malignancy and its most current treatment options. Most commonly presenting as a painless lump or thickening of skin on the eyelid, SC has an insidious progression that may not prompt the patient to seek medical attention immediately. To avoid the potential of metastasis, early diagnosis and treatment is paramount. To assess if the cancer has spread, ophthalmology, imaging, and sentinel lymph node biopsy are recommended. This article provides a comprehensive review of SC's pathogenesis, current diagnostic methods, and treatments, including wide local excision, Mohs micrographic surgery, orbital exenteration, radiation, and other topicals. The prognosis of SC depends on several factors, including size, location, stage, and treatment method. After treatment of the neoplasm, diligent post-treatment surveillance remains the cornerstone of patient care. Continued dermatologic follow-ups are essential for early detection of reoccurrence, ensuring timely intervention and optimal long-term outcomes. In conclusion, this comprehensive review aims to equip dermatologists and other physicians with a nuanced understanding of SC, enabling them to provide effective care to support patients encountering this malignancy.
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Affiliation(s)
- Caitlin Dowell-Esquivel
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Dermatology Research Clinic, 1150 NW 14th Street, Miami, FL, 33136, USA.
| | - Raphael Lee
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Dermatology Research Clinic, 1150 NW 14th Street, Miami, FL, 33136, USA
| | - Robert C DiCaprio
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Dermatology Research Clinic, 1150 NW 14th Street, Miami, FL, 33136, USA
| | - Keyvan Nouri
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Dermatology Research Clinic, 1150 NW 14th Street, Miami, FL, 33136, USA
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Kamyab-Hesari K, Azhari V, Ahmadzade A, Asadi Amoli F, Najafi A, Hasanzadeh A, Beikmarzehei A. Machine learning for classification of cutaneous sebaceous neoplasms: implementing decision tree model using cytological and architectural features. Diagn Pathol 2023; 18:89. [PMID: 37550731 PMCID: PMC10405381 DOI: 10.1186/s13000-023-01378-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 07/28/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND This observational study aims to describe and compare histopathological, architectural, and nuclear characteristics of sebaceous lesions and utilized these characteristics to develop a predictive classification approach using machine learning algorithms. METHODS This cross-sectional study was conducted on Iranian patients with sebaceous tumors from two hospitals between March 2015 and March 2019. Pathology slides were reviewed by two pathologists and the architectural and cytological attributes were recorded. Multiple decision tree models were trained using 5-fold cross validation to determine the most important predictor variables and to develop a simple prediction model. RESULTS This study assessed the characteristics of 123 sebaceous tumors. Histopathological findings, including pagetoid appearance, neurovascular invasion, atypical mitosis, extensive necrotic area, poor cell differentiation, and non-lobular tumor growth pattern, as well as nuclear features, including highly irregular nuclear contour, and large nuclear size were exclusively observed in carcinomatous tumors. Among non-carcinomatous lesions, some sebaceoma and sebaceous adenoma cases had features like high mitotic activity, which can be misleading and complicate diagnosis. Based on multiple decision tree models, the five most critical variables for lesion categorization were identified as: basaloid cell count, peripheral basaloid cell layers, tumor margin, nuclear size, and chromatin. CONCLUSIONS This study implemented a machine learning modeling approach to help optimally categorize sebaceous lesions based on architectural and nuclear features. However, studies of larger sample sizes are needed to ensure the accuracy of our suggested predictive model.
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Affiliation(s)
- Kambiz Kamyab-Hesari
- Department of Dermatopathology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahidehsadat Azhari
- Department of Dermatopathology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ahmadzade
- Medical school, Tehran University of Medical Sciences, Keshavarz Blvd, Tehran, Iran
| | - Fahimeh Asadi Amoli
- Department of Pathology, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Anahita Najafi
- Medical school, Tehran University of Medical Sciences, Keshavarz Blvd, Tehran, Iran
| | - Alireza Hasanzadeh
- Medical school, Tehran University of Medical Sciences, Keshavarz Blvd, Tehran, Iran
| | - Alireza Beikmarzehei
- Medical school, Tehran University of Medical Sciences, Keshavarz Blvd, Tehran, Iran.
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Tripathi R, Nijhawan RI, Bordeaux JS. Sebaceous carcinoma in solid organ transplant recipients: The elegant path from epidemiology to etiology. Cancer Epidemiol 2023; 84:102361. [PMID: 37062243 DOI: 10.1016/j.canep.2023.102361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 03/03/2023] [Accepted: 04/02/2023] [Indexed: 04/18/2023]
Abstract
Sebaceous carcinoma (SC) is a rare skin cancer associated with rapid progression and relatively poor survival, particularly in solid organ transplant recipients (SOTRs). Immunosuppressive regimens place SOTRs at substantially increased risk of a variety of skin cancers; recent research has shown a 25-fold increase in SC in the SOTR population, especially among lung recipients, older males, those with longer time since transplant, and patients undergoing induction therapy with thymoglobulin. The potential etiologic mechanisms underlying SC are multifaceted and complex. Immunosuppression creates a microcosm through which to view causative factors for carcinogenesis which has implications in elucidating mechanistic etiologies for SC far beyond the SOTR population, since not all cancers are more common in immunosuppressed patients. Research integrating the role of oncogenic viruses, underlying medical conditions, genetic risk factors, toxicity of prophylactic medications, drug-induced photosensitization, and T-cell deficiency/dysfunction is needed to better elucidate the factors underlying SC in immunosuppressed hosts. In this report, we integrate current research regarding SC in SOTR patients using the causal pie/sufficient-component cause model. In doing so, we provide a paradigm through which to view future research regarding the etiology of SC.
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Affiliation(s)
- Raghav Tripathi
- Johns Hopkins Medicine, Department of Dermatology, Baltimore, MD, USA.
| | - Rajiv I Nijhawan
- University of Texas Southwestern Medical Center, Department of Dermatology, Dallas, TX, USA
| | - Jeremy S Bordeaux
- Case Western Reserve University School of Medicine/University Hospitals Cleveland Medical Center, Department of Dermatology, Cleveland, OH, USA
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Mack D, Hussein MA, Sachwani-Daswani G, Wong K. Extraocular sebaceous carcinoma of the chest wall: A case report. Int J Surg Case Rep 2023; 106:108195. [PMID: 37068454 PMCID: PMC10130462 DOI: 10.1016/j.ijscr.2023.108195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/10/2023] [Accepted: 04/11/2023] [Indexed: 04/19/2023] Open
Abstract
INTRODUCTION Sebaceous carcinoma is a rare malignancy that is most commonly found in the head and neck region, particularly in the periocular region. Extraocular lesions are rarer, however are thought to have a higher association with Muir-Torre Syndrome, a variant of Lynch Syndrome, that affects both sebaceous glands and visceral organs. CASE PRESENTATION Our patient was a 54 year old male with a past medical history of hypertension, stroke, and vertigo who presented to the emergency department with paresthesias concerning for a transient ischemic attack in the setting of a hypertensive emergency. After admission, the patient reported an abscess on the chest that was present for four months prior. Subsequent physical exam incidentally revealed a fungating mass located on the chest wall. The mass was noted to have central ulceration and necrosis. CLINICAL DISCUSSION CT scan of the chest with intravenous contrast revealed that the mass did not invade the chest wall, therefore a surgical excision was performed. A final diagnosis of sebaceous carcinoma was made after microscopic examination of the resected mass. Immunohistochemistry revealed loss of expression of mismatch repair genes. The patient was lost to follow-up before any additional work up could be performed. CONCLUSION Extraocular sebaceous carcinomas should be tested using immunohistochemistry for loss of expression of mismatch repair genes. Patients with loss of expression should be risk stratified using the Mayo Muir-Torre risk score to determine if they should undergo germline genetic testing for Lynch Syndrome. Patients with issues in adherence represent a unique diagnostic challenge in potentially evolving diseases.
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Affiliation(s)
- Dakita Mack
- Department of General Surgery, Beaumont Health Farmington Hills, Farmington Hills, MI, USA
| | - Mohamed A Hussein
- Division of Trauma Surgery, Department of General Surgery, Hurley Medical Center, Flint, MI, USA
| | - Gul Sachwani-Daswani
- Division of Trauma Surgery, Department of General Surgery, Hurley Medical Center, Flint, MI, USA
| | - Kristoffer Wong
- Division of Trauma Surgery, Department of General Surgery, Hurley Medical Center, Flint, MI, USA.
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Frouin E, Alleyrat C, Godet J, Karayan-Tapon L, Sinson H, Morel F, Lecron JC, Favot L. The M2 macrophages infiltration of sebaceous tumors is linked to the aggressiveness of tumors but not to the mismatch repair pathway. J Cancer Res Clin Oncol 2023:10.1007/s00432-023-04629-x. [PMID: 36763173 DOI: 10.1007/s00432-023-04629-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 02/01/2023] [Indexed: 02/11/2023]
Abstract
PURPOSE The immune microenvironment of sebaceous neoplasms (SNs) has been poorly explored, especially in benign lesions, and never correlated to the mismatch repair (MMR) status. METHODS We conducted an immuno-histological study to analyze the immune microenvironment of SNs. A tissue microarray was constructed including sebaceous adenomas (SAs), sebaceomas (Ss) and sebaceous carcinomas (SCs) to performed immuno-histological analysis of T cells, B cells, macrophages, dendritic cells, and expression of Programmed Death-1 (PD-1) and Programmed Death Ligand 1 (PD-L1). An automatized count was performed using the QuPath® software. Composition of the cellular microenvironment was compared to the aggressiveness, the MMR status, and to Muir-Torre syndrome (MTS). RESULTS We included 123 SNs (43 SAs, 19 Ss and 61 SCs) for which 71.5% had a dMMR phenotype. A higher infiltration of macrophages (CD68 +) of M2 phenotype (CD163 +) and dendritic cells (CD11c +) was noticed in SCs compared to benign SNs (SAs and Ss). Programmed cell death ligand-1 but not PD-1 was expressed by more immune cells in SCs compared to benign SNs. No difference in the immune cell composition regarding the MMR status, or to MTS was observed. CONCLUSION In SNs, M2 macrophages and dendritic cells infiltrates are associated with the progression and the malignant transformation of tumors. High PD-L1 expression in immune cells in SCs is an argument for the use of immunotherapy by anti-PD1 or PD-L1 in metastatic patients. The lack of correlation between the composition of immune cells in SNs and the MMR status emphasizes the singularity of SNs among MMR-associated malignancies.
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Affiliation(s)
- Eric Frouin
- Pathology Department, University Hospital of Poitiers, Poitiers, France. .,LITEC, Université de Poitiers, Poitiers, France.
| | - Camille Alleyrat
- Plateforme Méthodologie Biostatistiques, Data-Management, University Hospital of Poitiers, 86073, Poitiers, France
| | - Julie Godet
- Pathology Department, University Hospital of Poitiers, Poitiers, France
| | - Lucie Karayan-Tapon
- ProDiCeT, Université de Poitiers, Poitiers, France.,Department of Cancer Biology, CHU de Poitiers, University Hospital of Poitiers, Poitiers, France
| | - Hélinie Sinson
- Pathology Department, University Hospital of Poitiers, Poitiers, France
| | | | - Jean-Claude Lecron
- LITEC, Université de Poitiers, Poitiers, France.,Department of Immunology and Inflammation, University Hospital of Poitiers, Poitiers, France
| | - Laure Favot
- LITEC, Université de Poitiers, Poitiers, France
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Di Cosola M, Spirito F, Ambrosino M, Somma P, Santarelli A, Staibano S, Lo Muzio L. Sebaceous carcinoma of the lip: a case report and review of the literature. J Med Case Rep 2022; 16:241. [PMID: 35715870 DOI: 10.1186/s13256-022-03435-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 04/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sebaceous carcinoma is a very rare, aggressive, malignant tumor arising in the adnexal epithelium of the sebaceous gland. Sebaceous carcinoma in the oral cavity is extremely rare, with only 14 cases reported in literature. We reported the fourth case of sebaceous carcinoma involving the lip CASE PRESENTATION: A 71-year-old Caucasian male smoker presented an ulcerated lesion in the lateral region of the lower lip. The patient stated that the lesion had been present for 1 year. The past medical history was unremarkable. Extraoral examination revealed a markedly ulcerated, exophytic, irregularly shaped, indurated mass of the lower right labial region, measuring 1.8 cm in size. The nodular lesion, located at the point of transition between mucosa and skin, showed a central ulceration. No other intraoral lesions were identified. The clinical differential diagnosis included squamous cell carcinoma, basal cell carcinoma with sebaceous differentiation, and salivary gland neoplasms. Operation was performed under local anesthesia. On histopathological examination, the tumor was composed by nodules or sheet of cells separated by a fibrovascular stroma. The neoplastic tissue was deeply infiltrating, involving the submucosa and even the underlying muscle. Neoplastic cells showed a range of sebaceous differentiation with finely vacuolated rather than clear cytoplasm. Neoplastic cells were positive for S-100 protein and epithelial membrane antigen, but negative for carcinoembryonic antigen. Based on these findings, a diagnosis of sebaceous carcinoma of the lower lip was rendered. CONCLUSION The histogenesis, differential diagnosis, and clinicopathological conditions of this disease according to literature are reviewed. Sebaceous carcinoma should be distinguished from other tumors full of vacuolated clear cells. A periodic acid-Schiff stain and immunohistochemical stain for Ki-67, P53, cytokeratin, S-100, epithelial membrane antigen, and androgen receptor can be useful for the diagnosis.
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Goto H, Yamakawa N, Komatsu H, Asakage M, Tsubota K, Ueda SI, Nemoto R, Shibata M, Umazume K, Usui Y, Mori H. Epidemiological characteristics of malignant eyelid tumors at a referral hospital in Japan. Jpn J Ophthalmol 2022; 66:343-349. [PMID: 35670924 DOI: 10.1007/s10384-022-00926-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 04/21/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE To clarify the incidence and demographic characteristics of malignant eyelid tumors diagnosed in a single institute in Japan. STUDY DESIGN Retrospective, observational case series METHODS: Patients with malignant eyelid tumors diagnosed histopathologically at Tokyo Medical University Hospital between 1995 and 2019 were reviewed retrospectively. The incidence and demographic profile of malignant eyelid tumors were analyzed. The number of benign eyelid tumors diagnosed histopathologically during the same period was also counted. RESULTS A total of 412 patients with histopathologically proven malignant eyelid tumors were included. The most common malignant eyelid tumor was sebaceous carcinoma (n = 180, 44%), followed by basal cell carcinoma (n = 148, 36%), squamous cell carcinoma (n = 35, 9%), lymphoma (n = 28, 7%), Merkel cell carcinoma (n = 11, 3%) and others (n = 10, 2%). Mean age of all patients with malignant eyelid tumor at the time of diagnosis was 71.0 ± 13.0 years. For sebaceous carcinoma, the proportion of female patients was significantly higher than that of male patients (P = 0.0283) and the proportion of involvement of upper eyelid was significantly higher than that of lower eyelid (P = 0.0001). On the other hand, there was no sex predominance in basal cell carcinoma and squamous cell carcinoma. The proportion of involvement of lower eyelid was significantly higher than of upper eyelid in basal cell carcinoma (P = 0.001) and squamous cell carcinoma (P = 0.0012). There were 1433 patients with benign eyelid tumors accounting for 78% of all eyelid tumors during the study period. CONCLUSIONS Sebaceous carcinoma is the major malignant eyelid tumor in Japan and is more frequent in women than in men. Epidemiology of malignant eyelid tumors may be affected by the trend of population age structure associated with the recent population aging.
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Affiliation(s)
- Hiroshi Goto
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
| | - Naoyuki Yamakawa
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Hiroyuki Komatsu
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Masaki Asakage
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Kinya Tsubota
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Shun-Ichiro Ueda
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Rei Nemoto
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Motoko Shibata
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Kazuhiko Umazume
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Yoshihiko Usui
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Hideki Mori
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
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Vissers G, Corthouts J, Van Haverbeke C, Declercq S, Mertens M. Misdiagnosis of sebaceous carcinoma. Acta Chir Belg 2022; 122:127-132. [PMID: 32375578 DOI: 10.1080/00015458.2020.1765674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Sebaceous carcinoma is an aggressive malignant tumour. To prevent mutilating surgery and improve patient outcomes, early diagnosis and prompt treatment are necessary. When the tumour invades surrounding tissues, treatment may become complex. METHODS We present a case report illustrating complex resection and reconstruction of a sebaceous carcinoma after initial misdiagnosis. RESULTS A 74-year-old man with a sebaceous carcinoma to his right upper eyelid had a delay in treatment due to initial misdiagnosis. Upon the correct diagnosis, computed tomography scan showed tumour invasion of the medial rectus muscle and tumour spread to the right parotid gland. An orbital exenteration, partial parotidectomy and selective cervical lymphadenectomy were performed. Frozen section examination showed false-free margins, as additional paraffin embedded sections showed uncomplete tumour resection. Adjuvant radiotherapy was offered to the patient. The treatment was complicated by radio necrosis, necessitating surgical reconstruction by a paramedian forehead flap. Final reconstruction of the right orbit was accomplished by a personalised epithesis. CONCLUSIONS Sebaceous carcinoma is a tumour that is often misdiagnosed. The aim of this case report is to emphasize the possible consequences of its misdiagnosis. An overview of characteristic clinical findings is provided to help reduce the number of misdiagnoses.
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Affiliation(s)
- Gino Vissers
- Department of Plastic Surgery, ZNA Middelheim Hospital, Antwerp, Belgium
- Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Jérôme Corthouts
- Department of Plastic Surgery, ZNA Middelheim Hospital, Antwerp, Belgium
- Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | | | - Sabine Declercq
- Department of Pathology, ZNA Middelheim Hospital, Antwerp, Belgium
| | - Marianne Mertens
- Department of Plastic Surgery, ZNA Middelheim Hospital, Antwerp, Belgium
- Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
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Loth C, Miller CV, Haritoglou C, Messmer ESBM. [Hordeolum and chalazion : (Differential) diagnosis and treatment]. Ophthalmologe 2021; 119:97-108. [PMID: 34379160 DOI: 10.1007/s00347-021-01436-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2021] [Indexed: 11/26/2022]
Abstract
Hordeolum and chalazion are the most frequent inflammatory eyelid tumors. They can occur in association with underlying diseases causing Meibomian gland dysfunction and/or chronic blepharitis. Due to the typical morphological features and clinical course, the diagnosis can mostly be clinically established. The majority of these lesions resolve spontaneously over time. In some instances, surgical intervention is unavoidable. In persistent, recurrent or clinically atypical cases malignant tumors must be excluded as a differential diagnosis by excisional biopsy and histopathological assessment.
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Affiliation(s)
- Christiane Loth
- Augenklinik Herzog Carl Theodor, Nymphenburger Str. 43, 80335, München, Deutschland.
| | | | - Christos Haritoglou
- Augenklinik Herzog Carl Theodor, Nymphenburger Str. 43, 80335, München, Deutschland
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Fathaddin A, Almukhadeb E. A Rare Occurrence of Sebaceous Carcinoma, Sebaceoma, Syringocystadenoma Papilliferum, and Trichoblastoma in a Single Nevus Sebaceous Lesion. Case Rep Dermatol 2021; 13:271-277. [PMID: 34177517 PMCID: PMC8215995 DOI: 10.1159/000516351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 04/06/2021] [Indexed: 11/19/2022] Open
Abstract
Nevus sebaceous (NS) is a benign tumor with the potential to develop secondary benign and malignant neoplasms. It is a rare phenomenon to develop 2 or more skin tumors in a single NS lesion. We report a case of multiple secondary tumors, such as sebaceoma, sebaceous carcinoma, syringocystadenoma papilliferum, and trichoblastoma, in a single NS lesion.
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Affiliation(s)
- Amany Fathaddin
- Department of Pathology, College of Medicine, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Eman Almukhadeb
- Department of Dermatology, College of Medicine, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia
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12
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Abstract
Sebaceous neoplasia primarily includes sebaceous adenoma, sebaceoma, and sebaceous carcinoma (SC). Sebaceous adenoma, sebaceoma, and a subset of cutaneous SC are frequently associated with defective DNA mismatch repair resulting from mutations in MLH1, MSH2, or MSH6. These tumors can be sporadic or associated with Muir-Torre syndrome. SCs without defective DNA mismatch repair have ultraviolet signature mutation or paucimutational patterns. Ocular SCs have low mutation burdens and frequent mutations in ZNF750. Some ocular sebaceous carcinomas have TP53 and RB1 mutations similar to cutaneous SC, whereas others lack such mutations and are associated with human papilloma virus infection.
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Affiliation(s)
- Jeffrey P North
- Dermatopathology, Department of Dermatology, University of California San Francisco, School of Medicine, 1701 Divisadero Street, Room 280, San Francisco, CA 94115, USA; Department of Pathology, University of California San Francisco, School of Medicine, 1701 Divisadero Street, Room 280, San Francisco, CA 94115, USA.
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13
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Yamamoto A, Chigusa Y, Fujimoto M, Yamanoi K, Minamiguchi S, Yasuda E, Hamanishi J, Kondoh E, Mandai M, Yamaguchi K. Sebaceous carcinoma of the vulva treated with sentinel lymph node biopsy: a case report and literature review. Int Cancer Conf J 2021; 10:239-243. [PMID: 34221839 DOI: 10.1007/s13691-021-00488-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 04/26/2021] [Indexed: 11/29/2022] Open
Abstract
Sebaceous carcinoma (SC) is a rare and aggressive cutaneous malignancy. It often occurs on the eyelid, where it is called periocular SC, while extraocular SC mainly occurs on the head and heck. Extraocular vulvar SC is extremely rare; only nine cases have been described in the literature, and the optimal treatment strategy is unknown. We herein report a case of vulvar SC that was successfully treated with local excision in combination with sentinel lymph node biopsy (SNB). A 66-year-old female presented with vulvar discomfort. An 8 mm ulcerated mass was palpable in her left labia minora. Skin biopsy suggested SC. Imaging showed no swelling of the pelvic and inguinal lymph nodes and no metastasis. Sentinel lymph node scintigraphy using technetium-99 m showed three sentinel lymph nodes. The patient underwent local excision with SNB; intraoperative frozen-section examination revealed no nodal metastasis, and no further inguinal lymphadenectomy was performed. The final diagnosis was SC of the vulva, FIGO stage IB (pT1bN0M0). At the 14-month follow-up, she remained asymptomatic and had no signs of recurrence. The scientific rationale for SNB in extraocular SC has not yet been established, although SNB can be considered for periocular SC. However, considering the insufficient data on the management of vulvar SC and the aggressive nature of both periocular and extraocular SCs, SNB can be a reasonable and useful method for avoiding inadequate treatment and reducing the complications caused by unnecessary inguinal lymphadenectomy.
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Affiliation(s)
- Ayaka Yamamoto
- Department of Gynecology and Obstetrics, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Yoshitsugu Chigusa
- Department of Gynecology and Obstetrics, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Masakazu Fujimoto
- Department of Diagnostic Pathology, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Koji Yamanoi
- Department of Gynecology and Obstetrics, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Sachiko Minamiguchi
- Department of Diagnostic Pathology, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Eriko Yasuda
- Department of Gynecology and Obstetrics, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Junzo Hamanishi
- Department of Gynecology and Obstetrics, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Eiji Kondoh
- Department of Gynecology and Obstetrics, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Masaki Mandai
- Department of Gynecology and Obstetrics, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Ken Yamaguchi
- Department of Gynecology and Obstetrics, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
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Saliba M, Shaheen M, Hajj RE, Abbas F, Bashir S, Sheikh UN, Mahfouz R, Loya A, Khalifeh I. PD-L1 expression in sebaceous carcinomas. Cancer Immunol Immunother 2021; 70:1907-1915. [PMID: 33398391 DOI: 10.1007/s00262-020-02821-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 12/06/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Traditional systemic treatments for unresectable, recurrent, and/or advanced sebaceous carcinoma (SC) are ineffective. Tumoral immune microenvironment characterization is essential for considering immune checkpoint inhibitors as a treatment option. METHODS A total of 173 resected SCs were reviewed. Clinical information, lesion size, and location were collected. Microscopic examination documented histopathologic features and expression of immunohistochemical markers PD-L1 and CD8. PD-L1 percentage was assessed amongst tumor (PD-L1 + Tu) and immune infiltrating cells (PD-L1 + Inf). Each case was attributed a combined positive score (CPS) following Head and Neck squamous cell carcinoma recommendations. PD-L1 expression was evaluated according to clinicopathologic parameters. Human Papilloma Virus presence (HPV) was analyzed using PCR microarray scanning. RESULTS A therapeutically relevant CPS was seen in 51.4% of cases. Higher PD-L1 + Tu, PD-L1 + Inf, and CPSs were positively associated with greater lesion size and an extraocular location. No association was seen with patient age or gender. 9.2% of SCs showed PD-L1 + Tu ≥ 1, while 52.0% showed PD-L1 + Inf ≥ 1. A higher CD8 + T-lymphocyte density was significantly associated with a higher CPS, PD-L1 + Tu, and PD-L1 + Inf. Tumor-associated T-cell infiltrate's density was higher along tumor periphery. HPV-16, HPV-43, HPV-52, and HPV-66 were detected in 8.4% of SCs. There was no significant association between HPV status, PD-L1 expression, and CPS. A significant number of SCs express PD-L1 at therapeutic levels. Nevertheless, PD-L1 expression shows a higher intertumoral heterogeneity, in extraocular than in biologically distinct periocular cases. CONCLUSION Our data support the need for large-scale prospective studies evaluating anti-PD-L1 immunotherapy mainly in extraocular SC treatment.
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Affiliation(s)
- Maelle Saliba
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Cairo Street, Beirut, Lebanon
| | - Muhammad Shaheen
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Cairo Street, Beirut, Lebanon
| | - Rana El Hajj
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Cairo Street, Beirut, Lebanon
| | - Fatmeh Abbas
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Cairo Street, Beirut, Lebanon
| | - Shaarif Bashir
- Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Umer Nisar Sheikh
- Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Rami Mahfouz
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Cairo Street, Beirut, Lebanon
| | - Asif Loya
- Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Ibrahim Khalifeh
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Cairo Street, Beirut, Lebanon.
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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. Curr Health Sci J 2021; 47:595-601. [PMID: 35444817 DOI: 10.12865/CHSJ.47.04.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [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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16
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Goyal A, Marghitu T, Goyal N, Rubin N, Patel K, Goyal K, O'Leary D, Bohjanen K, Maher I. Surgical management and lymph-node biopsy of rare malignant cutaneous adnexal carcinomas: a population-based analysis of 7591 patients. Arch Dermatol Res 2020; 313:623-632. [PMID: 32965516 DOI: 10.1007/s00403-020-02143-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/21/2020] [Accepted: 09/12/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To analyze the prognosis of cutaneous adnexal malignancies, survival relative to surgical management, and utility of lymph-node biopsy. DESIGN Population-based study of the SEER-18 database from 1975 to 2016. PARTICIPANTS 7591 patients with sweat gland carcinoma, hidradenocarcinoma, spiradenocarcinoma, sclerosing sweat duct tumor/microcystic adnexal tumor (SSDT/MAC), porocarcinoma, eccrine adenocarcinoma, and sebaceous carcinoma RESULTS: Five-year OS ranged from 68.0 to 82.6%, while 5-year DSS ranged from 94.6 to 99.0%. The majority of patients were treated with narrow (42.4%) or wide local excision (16.9%). DSS at 5 years showed that patients with stage IV had significantly poorer survival (50.3%) than I, II, or III (99.3%, 97.8%, and 89.0% respectively). 5-year OS was significantly higher for narrow excision (excision with < 1 cm margin, 78.5%) than observation (65.0%), excisional biopsy (66.8%), or wide local excision (WLE, 73.2%). Lymph-node biopsy was performed in a minority of cases (8.1%) and patients showed no significant difference in survival based on nodal status. The sensitivity and specificity of lymph-node biopsy for all malignancies were 46% and 80%, respectively. The PPV and NPV for that group were 0.46 and 0.80, respectively. Invasion of deep extradermal structures was a poor predictor of nodal positivity. CONCLUSIONS These malignancies have excellent DSS. Narrow excisions demonstrate better 5-year DSS and OS compared with WLE. Lymph-node biopsy is a poor predictor of survival in advanced stage disease and utility is limited.
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Affiliation(s)
- Amrita Goyal
- Department of Dermatology, University of Minnesota, 516 Delaware St SE, Minneapolis, MN, 55401, USA.
| | | | - Nikhil Goyal
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Nathan Rubin
- Biostatistics Core, Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Krishnan Patel
- Division of Hematology, Oncology, and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Kavita Goyal
- Department of Dermatology, University of Minnesota, 516 Delaware St SE, Minneapolis, MN, 55401, USA
| | - Daniel O'Leary
- Department of Radiation Oncology, University of Minnesota, Minneapolis, MN, USA
| | - Kimberly Bohjanen
- Department of Dermatology, University of Minnesota, 516 Delaware St SE, Minneapolis, MN, 55401, USA
| | - Ian Maher
- Department of Dermatology, University of Minnesota, 516 Delaware St SE, Minneapolis, MN, 55401, USA
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Goto H, Tsubota K, Nemoto R, Ueda S, Umazume K, Usui Y, Matsumura H. Clinical features and prognosis of sebaceous carcinoma arising in the eyelid or conjunctiva. Jpn J Ophthalmol 2020; 64:549-554. [PMID: 32642990 DOI: 10.1007/s10384-020-00756-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 05/21/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The aim of this study was to clarify the demographics, clinical features, and outcomes of Japanese patients with sebaceous carcinoma of the eyelid or conjunctiva. STUDY DESIGN Retrospective study. METHODS One hundred twenty-five patients with sebaceous carcinoma of the eyelid or conjunctiva diagnosed at Tokyo Medical University Hospital between 1994 and 2017 were reviewed. The outcomes of the 116 patients who were treated and followed for at least 24 months at our hospital were investigated. RESULTS The patients reviewed comprised 52 men and 74 women. The average age at diagnosis was 70.6 ± 13.8 (range 31-96) years. The main lesion was located in the upper eyelid in 51% of the patients; in the lower eyelid in 38% of the patients; and in other regions in 11% of the patients. Treatments included surgical resection with or without eyelid reconstruction in 108 cases (93%), orbital exenteration in 5 cases (4%), and radiation therapy in 3 cases (3%). Local recurrence was detected in 11 cases (9%). Metastasis to the regional lymph nodes was confirmed in 10 cases (9%). Four patients (3%) died because of direct intracranial invasion of the tumor. Risk of local recurrence and metastasis was significantly related to larger tumor size. CONCLUSION Proper diagnosis and treatment at the optimal timing is critical to improve the outcome of sebaceous carcinoma of the eyelid or conjunctiva. Long-term follow-up is required because local recurrence and metastasis may occur several years after treatment.
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Affiliation(s)
- Hiroshi Goto
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
| | - Kinya Tsubota
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Rei Nemoto
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Shunichiro Ueda
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Kazuhiko Umazume
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Yoshihiko Usui
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Hajme Matsumura
- Department of Plastic Surgery, Tokyo Medical University, Tokyo, Japan
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18
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Leivo T, Sarmela J, Enckell-Aaltonen M, Dafgård Kopp E, Schmitt C, Toft PB, Sigurdsson H, Uusitalo M. Nordic treatment practices survey and consensus for treatment of eyelid sebaceous carcinoma. BMC Ophthalmol 2020; 20:103. [PMID: 32178641 PMCID: PMC7074984 DOI: 10.1186/s12886-020-01367-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 03/04/2020] [Indexed: 12/03/2022] Open
Abstract
Background The purpose was to describe the Nordic treatment practices and to reach a Nordic consensus for the treatment of sebaceous eyelid carcinoma. Methods The treatment practices data was collected by a questionnaire with 37 questions to the Nordic oculoplastic surgeons and analyzed. A PubMed MEDLINE database search was done to gather data on the published treatment practices and recommendations. A working group that consisted of in minimum one senior consultant from each leading Nordic University Eye Hospital was assigned. A structured interactive method was used to establish the consensus. Results Twenty-four doctors responded to the questionnaire. 23/24 (96%) of the respondents took a biopsy before surgery. Regional lymph node scanning was routinely done by 14/23 (61%) and a systemic screening of a metastatic disease by 13/23 (57%). 6/22 (27%) never took conjunctival mapping biopsies and 12/23 (52%) never screened for Muir- Torre. Respondents used Mohs surgery, frozen section or multi-stage excision with delayed closure, and 5–6 mm was the mostly preferred margin. Sentinel lymph node biopsy was a possible option for 9/22 (41%) and cryotherapy and Mitomycin C for 6/22 (27%) respondents. 50% of respondents considered radiation as a treatment option. 15/16 (94%) respondents always followed-up their patients, most for 5 years. Two thirds scanned regional lymph nodes during the follow-up. Consensus was reached for 18 statements representing three domains: preoperative work-up, treatment and follow-up. Conclusion Treatment practices differ in between the five Nordic countries which have similar public health care systems. In the article the authors present a Nordic consensus for the treatment of eyelid sebaceous carcinoma.
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Affiliation(s)
- Tiina Leivo
- Department of Ophthalmology, Helsinki University Hospital and University of Helsinki, PO Box 220, FI-00029 HUS, Helsinki, Finland.
| | - Johanna Sarmela
- Department of Ophthalmology, Helsinki University Hospital and University of Helsinki, PO Box 220, FI-00029 HUS, Helsinki, Finland
| | - Maria Enckell-Aaltonen
- Department of Ophthalmology, Helsinki University Hospital and University of Helsinki, PO Box 220, FI-00029 HUS, Helsinki, Finland
| | - Eva Dafgård Kopp
- Department of Ophthalmology, S:t Erik's Eye Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Caroline Schmitt
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
| | - Peter B Toft
- Department of Ophthalmology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Haraldur Sigurdsson
- Department of Ophthalmology, Landspitali, University of Iceland, Reykjavik, Iceland
| | - Marita Uusitalo
- Department of Ophthalmology, Helsinki University Hospital and University of Helsinki, PO Box 220, FI-00029 HUS, Helsinki, Finland
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Ohno K, Okada T, Nakamura T, Koyama H. Sebaceous carcinoma of the breast predominantly characterized by intraductal growth: a case report. Surg Case Rep 2020; 6:41. [PMID: 32095941 PMCID: PMC7040145 DOI: 10.1186/s40792-020-0799-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 01/28/2020] [Indexed: 02/07/2023] Open
Abstract
Background Sebaceous carcinoma (SC) is frequently classified as periocular or extraocular. Extraocular SC is rare and mainly occurs in the head and neck, the major salivary glands, or oral mucosa. SC of the breast, lung, and ovary is particularly rare, and the few cases of SC of the breast predominantly exhibit intraductal growth. Case presentation A 47-year-old Japanese woman was referred to our hospital with accumulated polymorphic calcification in the left breast which was detected using mammography. Ultrasonography revealed an irregular 13-mm mass in the left breast, and analysis of a core needle biopsy revealed noninvasive ductal carcinoma. Total mastectomy and sentinel lymph node biopsy were performed. Histopathology demonstrated that carcinoma in situ (CIS) represented a significant lesion, and the cytoplasm of tumor cells was clear with numerous minute vacuoles. Immunohistochemical analysis demonstrated that most tumor cells expressed adipophilin. Together, these findings led to a diagnosis of SC, mainly comprising CIS. Conclusions We encountered a rare case of SC of the breast with predominant CIS.
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Affiliation(s)
- Koichi Ohno
- Department of Breast and Endocrine Surgery, Suwa Red Cross Hospital, 5-11-50, Kogan-douri, Suwa, Nagano, 392-8510, Japan.
| | - Toshihiro Okada
- Department of Breast and Endocrine Surgery, Suwa Red Cross Hospital, 5-11-50, Kogan-douri, Suwa, Nagano, 392-8510, Japan
| | - Toshitsugu Nakamura
- Department of Diagnostic Pathology, Suwa Red Cross Hospital, 5-11-50, Kogan-douri, Suwa, Nagano, 392-8510, Japan
| | - Hiroshi Koyama
- Koyama Clinic, 1-2557-1, Jonan, Suwa, Nagano, 392-0017, Japan
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Kopsidas K, Ford R, Ahmed I, Coupland SE. Concomitant Orbital Tumours: Small Lymphocytic Lymphoma Involving the Lacrimal Gland of a Patient with Clinical Diagnoses of Muir-Torre Syndrome and Extensive Sebaceous Gland Carcinoma of the Ipsilateral Eyelid. Ocul Oncol Pathol 2020; 6:15-19. [PMID: 32002399 DOI: 10.1159/000500161] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 03/14/2019] [Indexed: 11/19/2022] Open
Abstract
Background/Aims We present a case of 2 concomitant tumours, i.e., a sebaceous carcinoma (SC) and a small lymphocytic lymphoma (SLL), in the lacrimal gland of a patient with Muir-Torre syndrome. Methods Clinical history, orbital examination, diagnostic biopsy, excisional biopsy, and histopathologic analysis were utilized. Results An 89-year-old female presented to the eye casualty with corneal ulcer, anterior uveitis, proptosis, and restricted ocular motility. She has a clinical history of breast cancer, colon carcinoma, and SC of the eyelid, which had been resected completely 2 years before. Clinical examination, imaging, and diagnostic biopsy confirmed orbital SC recurrence. Exenteration and subsequent histopathologic analysis of the specimen revealed lymphocytic infiltrates consistent with SLL within the lacrimal gland. Conclusion We report for the first time a case of a patient with Muir-Torre syndrome who developed an orbital recurrent SC with an incidental finding of a lacrimal gland B non-Hodgkin lymphoma consistent with SLL. Clinicians should be aware of the possibility of this coexistence of multiple cancer types in patients with sebaceous carcinoma and Muir-Torre syndrome.
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Affiliation(s)
| | | | - Ibrar Ahmed
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, United Kingdom
| | - Sarah E Coupland
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, United Kingdom
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21
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Jakobiec FA, Cortes Barrantes P, Milman T, Yoon M. Sebaceoma of a Meibomian Gland of the Upper Eyelid. Ocul Oncol Pathol 2020; 6:297-304. [PMID: 33005621 DOI: 10.1159/000504627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 11/06/2019] [Indexed: 11/19/2022] Open
Abstract
Over a period of 1 year, a 74-year-old man slowly developed a painless left upper eyelid intratarsal mass. The skin was movable over the lesion. At surgery, a well-circumscribed, yellow-white, partially cystic tumor was encountered. Histopathologically it was composed of a random mixture of basaloid and sebaceous cells arranged in interconnecting cords. Immunohistochemical evaluation disclosed epithelial membrane antigen, adipophilin, and cytokeratin 14 positivity. These findings led to the diagnosis of a sebaceoma. The tumor cells abnormally failed to express mismatch repair proteins for MLH1 and PMS2. The patient did not have a personal history of any visceral malignancy, but his father had died at the age of 46 years and a daughter at the age of 33 years from colonic carcinomas. The implications of this periocular sebaceoma for the Muir-Torre syndrome are explored.
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Affiliation(s)
- Frederick A Jakobiec
- David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts Eye and Ear/Harvard Medical School, Boston, Massachusetts, USA
| | - Paula Cortes Barrantes
- David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts Eye and Ear/Harvard Medical School, Boston, Massachusetts, USA
| | - Tatyana Milman
- Department of Ophthalmic Pathology, Wills Eye Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Michael Yoon
- Department of Oculoplastics, Massachusetts Eye and Ear/Harvard Medical School, Boston, Massachusetts, USA
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Tomonari M, Shimada M, Nakada Y, Yamamoto I, Itoh M, Koike Y, Kobayashi A, Miki J, Yamada H, Kimura T, Saito S, Sugano K, Sekine S, Yamamoto H, Asahina A, Yokoo T. Muir-Torre syndrome: sebaceous carcinoma concurrent with colon cancer in a kidney transplant recipient; a case report. BMC Nephrol 2019; 20:394. [PMID: 31664942 DOI: 10.1186/s12882-019-1592-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 10/15/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Sebaceous carcinoma is a rare but progressive malignant skin cancer, and the incidence is approximately five times higher in post-transplant patients than in people who have not received kidney transplants. Sebaceous carcinoma is sometimes found concurrently with visceral cancers and a genetic abnormality, Muir-Torre syndrome. We report the case of a female kidney transplant recipient with sebaceous carcinoma concurrent with colon cancer 10 years after transplantation. CASE PRESENTATION A 43-year-old woman was admitted due to a rapidly progressive tumor on her head. Histologically, the tumor was diagnosed as sebaceous carcinoma. We diagnosed her with Muir-Torre syndrome based on the following evidence: 1) high prevalence of microsatellite instability in gene locus assay, 2) absence of mismatch repair proteins in the sebaceous carcinoma on immunohistochemical analysis, and 3) a genetic mutation of 1226_1227delAG in the MSH2 exon 7 in the lesion detected by DNA sequencing analysis. Several reports have shown an association between immunosuppressive agents and latent Muir-Torre syndrome progression. Therefore, the progression of colon cancer in this case originated from her genetic mutation for Muir-Torre syndrome and long-term use of immunosuppressive agents. CONCLUSION This case report not only highlights the importance of adequate diagnosis and therapy for Muir-Torre syndrome, but also suggests the further prevention of the development of malignant tumors in kidney transplant recipients. Physicians should be mindful that sebaceous carcinoma in kidney transplant recipients is highly concurrent with Muir-Torre syndrome.
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Kibbi N, Worley B, Owen JL, Kelm RC, Bichakjian CK, Chandra S, Demirci H, Kim J, Nehal KS, Thomas JR, Poon E, Alam M. Sebaceous carcinoma: controversies and their evidence for clinical practice. Arch Dermatol Res 2019; 312:25-31. [PMID: 31471636 DOI: 10.1007/s00403-019-01971-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 08/16/2019] [Accepted: 08/20/2019] [Indexed: 12/14/2022]
Abstract
Sebaceous carcinoma (SC) is a potentially aggressive malignancy of periocular or extraocular skin. It arises sporadically or is associated with Muir-Torre syndrome (MTS). Here, we review three controversial clinical conundra related to the diagnosis and treatment of SC and offer evidence-based recommendations. First, following a diagnosis of SC, deciding which patients to screen for MTS can be challenging. The Mayo MTS Risk Score is a clinical score that incorporates the key cutaneous findings in MTS but relies heavily on personal and family history that may not be available at the time of SC diagnosis, especially in young patients. Young patients, who have extraocular SC and are suspected to have MTS though do not meet criteria by Mayo MTS Risk Score, should have their tumors tested using immunohistochemistry for mismatch repair proteins. Second, sentinel lymph node biopsy (SLNB) is used in periocular SC to evaluate nodal disease. Patient selection is critical for SLNB. Periocular SC stage ≥ T2c (by American Joint Commission on Cancer, 8th edition) may be considered for SLNB given positivity rates over fifteen percent in expert hands. Lastly, treatment of metastatic SC is an area of active investigation. When possible, tumor profiling may be used to select targeted agents. Future research into these three key questions is needed.
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Affiliation(s)
- Nour Kibbi
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - Brandon Worley
- Division of Dermatology, The Ottawa Hospital, Ottawa, ON, Canada
| | - Joshua L Owen
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Ryan C Kelm
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Sunandana Chandra
- Division of Oncology, Department of Medicine, Northwestern University Medical Center, Chicago, IL, USA
| | - Hakan Demirci
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - John Kim
- Department of Plastic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Kishwer S Nehal
- Dermatology Service, Memorial Sloan Kettering, New York, NY, USA
| | - J Regan Thomas
- Department of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Emily Poon
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Murad Alam
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. .,Department of Dermatology, Northwestern Memorial Hospital, Arkes Family Pavilion, 676 N Saint Clair Suite 1600, Chicago, IL, 60611, USA.
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24
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Porubsky S, Jessup P, Kee D, Sharma R, Ochi A, Xu H, Froelich JJ, Nott L, Scott C, Awad R, Moldovan C, Hardikar AA, Bohnenberger H, Küffer S, Ströbel P, Marx A. Potentially actionable FGFR2 high-level amplification in thymic sebaceous carcinoma. Virchows Arch 2020; 476:323-7. [PMID: 31401665 DOI: 10.1007/s00428-019-02644-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 07/30/2019] [Accepted: 08/02/2019] [Indexed: 10/26/2022]
Abstract
Our aim was to investigate sebaceous differentiation in thymus tumours and to identify new actionable genomic alterations. To this end we screened 35 normal and 23 hyperplastic thymuses, 127 thymomas and 41 thymic carcinomas for the presence of sebaceous differentiation as defined by morphology and expression of adipophilin and androgen receptor (AR). One primary thymic carcinoma showed morphology of sebaceous carcinomas (keratinizing and foam cells, calcifications, giant cells), a strong expression of adipophilin and AR together with squamous markers. NGS revealed high-level amplification of fibroblast growth factor receptor 2 (FGFR2). In thymuses and thymomas, no cells with sebaceous morphology were present. Occasionally, macrophages or epithelial cells showed adipophilin-positivity, however, without co-expression of AR. Thymic sebaceous carcinoma should be considered if a thymic carcinoma shows clear or foamy features. Testing for FGFR2 amplification might be warranted when searching for actionable genomic alterations in sebaceous carcinomas in the mediastinum and in other locations.
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25
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Burris CKH, Rodriguez ME, Raven ML, Reddy DN, Xu YG, Wiggs JL, Potter HD, Albert DM. Muir-Torre Syndrome: The Importance of a Detailed Family History. Case Rep Ophthalmol 2019; 10:180-185. [PMID: 31692600 PMCID: PMC6760355 DOI: 10.1159/000500662] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 03/24/2019] [Indexed: 12/24/2022] Open
Abstract
Muir-Torre syndrome, a variant of Lynch syndrome or hereditary nonpolyposis colorectal cancer, is an autosomal dominant disease characterized by skin neoplasms (sebaceous or keratoacanthomas) and visceral malignancies. Due to the rarity of the syndrome there are no firm guidelines on how and when to test patients with its typical skin lesions. We describe a case that highlights the importance of a detailed family history.
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Affiliation(s)
- Christopher K H Burris
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin, USA
| | - Maria E Rodriguez
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin, USA
| | - Meisha L Raven
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin, USA
| | - Devasis N Reddy
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin, USA
| | - Yaohui G Xu
- Department of Dermatology, University of Wisconsin, Madison, Wisconsin, USA
| | - Janey L Wiggs
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Heather D Potter
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin, USA
| | - Daniel M Albert
- Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, USA
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26
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Tripathy D, Bothra N, Mittal R. Pedunculated poorly differentiated papillary sebaceous carcinoma of the eyelid. Orbit 2019; 39:311-312. [PMID: 31020881 DOI: 10.1080/01676830.2019.1600149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Devjyoti Tripathy
- Ophthalmic Plastics, Orbit and Ocular Oncology Services, LV Prasad Eye Institute , Bhubaneswar, Odisha
| | - Nandini Bothra
- Ophthalmic Plastics, Orbit and Ocular Oncology Services, LV Prasad Eye Institute , Bhubaneswar, Odisha
| | - Ruchi Mittal
- Kanupriya Dalmia Ophthalmic Pathology Laboratory, LV Prasad Eye Institute , Bhubaneswar, Odisha
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27
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Ota S, Sakamoto T, Ochiai R, Haruyama T, Ishihara M, Natsume M, Fukasawa Y, Tanzawa S, Usui R, Honda T, Ichikawa Y, Watanabe K, Sasajima Y, Mizota A, Seki N. Successful Treatment with Taxane-Based Chemotherapy in Advanced Sebaceous Carcinoma: A Case Report and Literature Review. Case Rep Oncol 2019; 12:47-52. [PMID: 30792644 PMCID: PMC6381883 DOI: 10.1159/000493850] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 09/13/2018] [Indexed: 11/28/2022] Open
Abstract
For sebaceous carcinoma (SC), a rare malignant tumor, no standard chemotherapy regimen for patients with distant metastasis has been studied. We experienced a case of eyelid SC with multiple lung metastases that responded to combination chemotherapy with carboplatin and paclitaxel with 11-month progression-free survival (PFS). This patient also responded to second-line treatment with docetaxel, another taxane, with 7-month PFS, resulting in at least 18 months of survival at the time of reporting. This report shows that taxane-based chemotherapy may be effective for advanced SC, for which no standard therapy has been established.
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Affiliation(s)
- Shuji Ota
- Division of Medical Oncology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Takahiko Sakamoto
- Division of Medical Oncology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Ryosuke Ochiai
- Division of Medical Oncology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Terunobu Haruyama
- Division of Medical Oncology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Masashi Ishihara
- Division of Medical Oncology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Maika Natsume
- Division of Medical Oncology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Yoko Fukasawa
- Division of Medical Oncology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Shigeru Tanzawa
- Division of Medical Oncology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Ryo Usui
- Division of Medical Oncology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Takeshi Honda
- Division of Medical Oncology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Yasuko Ichikawa
- Division of Medical Oncology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Kiyotaka Watanabe
- Division of Medical Oncology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Yuko Sasajima
- Department of Pathology, Teikyo University School of Medicine, Tokyo, Japan
| | - Atsushi Mizota
- Department of Ophthalmology, Teikyo University School of Medicine, Tokyo, Japan
| | - Nobuhiko Seki
- Division of Medical Oncology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
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28
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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29
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Park H, Choi SG. Primary sebaceous carcinoma of lacrimal gland: A case report and review of literature. World J Clin Cases 2018; 6:1194-1198. [PMID: 30613681 PMCID: PMC6306633 DOI: 10.12998/wjcc.v6.i16.1194] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 11/12/2018] [Accepted: 11/24/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Primary sebaceous carcinoma of lacrimal gland (SCLG) is extremely rare. Due to its clinical characteristics, it is often misdiagnosed. It is known to be aggressive so delay in diagnosis can increase the chance of local recurrence and metastasis. We report a case of primary SCLG.
CASE SUMMARY A 75-year-old man was referred with a painful swelling in the right eyelid. Computed tomography scan demonstrates a 2.6 cm mass in upper outer quadrant of right orbit. After the incisional biopsy of the mass, he was diagnosed with squamous cell carcinoma of lacrimal gland. A right orbital exenteration, cervical lymph node dissection was performed. There was no involvement of the overlying periorbital skin, eyelid, or conjunctiva. Histological examination of the exenteration specimen showed tumor arising from the lacrimal gland, which had been entirely replaced by sebaceous carcinoma with sarcomatous and squamous differentiation. Neoplastic cells which were large and contained prominent nucleoli. Focal tumor remained in the posterior resection margin. Patient underwent adjuvant radiotherapy, total dose of 56 Gy with dose-per-fraction 2 Gy to primary lesion. There has been no sign of recurrence until 2-years follow-up.
CONCLUSION We report a rare case of sebaceous carcinoma arising from the lacrimal gland. Accurate diagnosis of SCLG is important for appropriate treatment and prognosis prediction.
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Affiliation(s)
- Hyojung Park
- Departments of Radiation Oncology, Dankook University Hospital, Dankook University College of Medicine, Cheonan 31116, South Korea
| | - Sang Gyu Choi
- Departments of Radiation Oncology, Dankook University Hospital, Dankook University College of Medicine, Cheonan 31116, South Korea
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30
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Brownstein S, Mehta S, Nijhawan N, Allaire G, Nguyen TQT, Tang T, Jiang K, Saleh S, Kalin-Hajdu E, Bruen R, Oestrelcher J. Regression of Sebaceous Carcinoma of the Eyelid after a Small Incisional Biopsy: Report of Two Cases. Ocul Oncol Pathol 2018; 5:252-257. [PMID: 31367586 DOI: 10.1159/000490706] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 06/07/2018] [Indexed: 02/01/2023] Open
Abstract
Purpose To report 2 cases of regression of sebaceous carcinoma of the eyelid after a small incisional biopsy. Methods Clinical, imaging, and histopathological findings are presented, with a literature review on regressing ocular tumors. Results Our first patient was a 79-year-old man who presented with a 10-month history of progressive left upper eyelid ptosis caused by an eyelid tumor with orbital involvement and confirmed on magnetic resonance imaging. Our second patient was a 70-year-old woman who presented with ptosis with a left upper eyelid mass. Both patients underwent a small incisional biopsy of their lesion. The histopathological diagnoses in both cases were consistent with sebaceous carcinoma. Both patients refused exenteration. Follow-up clinical examination and imaging disclosed total regression of the ptosis and of the neoplasm with no sign of recurrence in both patients over a 4-year period for Case 1 and a 7-year period for Case 2. Conclusion Regression following incisional biopsy of basal cell, squamous cell, and Merkel cell carcinoma, including of the eyelid, is well documented. To the best of our knowledge, our 2 cases of sebaceous carcinoma are the first to be reported with total involution clinically and on imaging of the tumor following partial incisional biopsy.
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Affiliation(s)
- Seymour Brownstein
- Department of Ophthalmology, The Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada.,Department Pathology, The Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada
| | - Sonul Mehta
- Department of Ophthalmology, University of Toronto, Toronto, Ontario, Canada
| | - Navdeep Nijhawan
- Department of Ophthalmology, University of Toronto, Toronto, Ontario, Canada
| | - Guy Allaire
- Department of Pathology, University of Montreal, Montreal, Québec, Canada
| | | | - Tina Tang
- Department of Ophthalmology, The Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada.,Department Pathology, The Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada
| | - Kailun Jiang
- Department of Ophthalmology, The Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada.,Department Pathology, The Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada
| | - Solin Saleh
- Department of Ophthalmology, The Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada.,Department Pathology, The Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada
| | - Evan Kalin-Hajdu
- Department of Ophthalmology, University of Montreal, Montreal, Québec, Canada
| | - Robbin Bruen
- Department of Ophthalmology, University of Montreal, Montreal, Québec, Canada
| | - James Oestrelcher
- Department of Ophthalmology, University of Toronto, Toronto, Ontario, Canada
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31
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Wield A, Hodeib M, Khan M, Gubernick L, Li AJ, Kandukuri S. Sebaceous carcinoma arising within an ovarian mature cystic teratoma: A case report with discussion of clinical management and genetic evaluation. Gynecol Oncol Rep 2018; 26:37-40. [PMID: 30225334 DOI: 10.1016/j.gore.2018.08.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 08/27/2018] [Accepted: 08/28/2018] [Indexed: 12/22/2022] Open
Abstract
Sebaceous carcinomas are rare tumors, with the majority of described cases occurring within the eyelid. To date, there are nine documented reports of sebaceous carcinoma arising within a mature cystic teratoma of the ovary. Although the majority of cases originate from idiopathic mutations, there exists a strong association between this rare tumor and hereditary syndromes of DNA mismatch repair deficiency, such as Lynch syndrome and the lesser-known Muir-Torre syndrome. Here we present the case of a 67 year-old woman with a longstanding history of a small left ovarian cyst with sonographic features of an ovarian dermoid. After nine years, the left adnexal mass was noted to have enlarged, and she underwent a laparoscopic bilateral salpingo-oophorectomy. The final pathology was reported as sebaceous carcinoma arising within a mature cystic teratoma. The patient underwent subsequent surgical staging and has been followed for eight months without evidence of disease. This report includes a review of the current literature, as well as a brief discussion of the clinical management of women with sebaceous carcinoma arising within a mature teratoma. Additionally, we comment on the broader, hereditary significance of a diagnosis of sebaceous carcinoma, and use this case to demonstrate the thorough histologic and genetic evaluation that is recommended for patients diagnosed with this rare tumor.
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32
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Domingo-Musibay E, Murugan P, Giubellino A, Sharma S, Steinberger D, Yuan J, Hunt MA, Lou E, Miller JS. Near complete response to Pembrolizumab in microsatellite-stable metastatic sebaceous carcinoma. J Immunother Cancer 2018; 6:58. [PMID: 29914578 PMCID: PMC6006706 DOI: 10.1186/s40425-018-0357-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 05/15/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Sebaceous carcinoma is an aggressive adnexal skin tumor with a predilection for the eyelids and sebaceous glands of the head and neck. CASE PRESENTATION A 73 year-old man presented with confusion and was found to have widely disseminated sebaceous carcinoma with metastases to brain, lungs, liver, bowel, lymph nodes, and bone. Following initial treatment of the brain metastases with surgery he received post-operative radiosurgery. He then began systemic immunotherapy with pembrolizumab. After 6 months, he developed a near complete response to therapy by irRECIST and RECIST v.1.1. The response was associated with circulating CD8+ T cells with central memory (CM) and effector memory (EM) phenotype and mature CD16 + CD57+ NK cells. During treatment the patient developed adrenal insufficiency requiring high-dose systemic corticosteroids and later adrenal replacement therapy. After 12-months of follow-up he showed imaging evidence of progression in liver, mediastinum, and abdominal lymph nodes. Given persistent, strong PD-L1 expression he resumed pembrolizumab therapy and showed radiographic evidence of an ongoing response to therapy. CONCLUSIONS This is the first report describing objective clinical and radiographic responses following immunotherapy for widely metastatic sebaceous carcinoma. The dramatic therapeutic response to pembrolizumab was associated with peripheral blood circulating memory T cells and mature Natural Killer cells after 6 months (24 weeks) of therapy. This report supports prospective clinical trials of anti-PD1 checkpoint blockade for metastatic sebaceous carcinoma.
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Affiliation(s)
- Evidio Domingo-Musibay
- Department of Medicine, Division of Hematology, Oncology and Transplantation, University of Minnesota, 420 Delaware Street SE, MMC480, Minneapolis, MN, 55455, USA.
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, USA.
| | - Paari Murugan
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, 55455, USA
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Alessio Giubellino
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, 55455, USA
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Sandeep Sharma
- Department of Radiology, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Daniel Steinberger
- Department of Radiology, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Jianling Yuan
- Department of Radiation Oncology, University of Minnesota, Minneapolis, MN, 55455, USA
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Matthew A Hunt
- Department of Neurosurgery, University of Minnesota, Minneapolis, MN, 55455, USA
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Emil Lou
- Department of Medicine, Division of Hematology, Oncology and Transplantation, University of Minnesota, 420 Delaware Street SE, MMC480, Minneapolis, MN, 55455, USA
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Jeffrey S Miller
- Department of Medicine, Division of Hematology, Oncology and Transplantation, University of Minnesota, 420 Delaware Street SE, MMC480, Minneapolis, MN, 55455, USA
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, USA
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Monai N, Tanabu R, Gonome T, Yokoi K, Urushidate S, Morohashi S, Hirai H, Kurose A, Nakazawa M. Intraoperative Adjunctive Mitomycin C and Cryotherapy for Recurrent Conjunctival Papillary Sebaceous Carcinoma. Case Rep Ophthalmol 2018; 9:221-226. [PMID: 29681840 PMCID: PMC5903128 DOI: 10.1159/000487704] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 02/13/2018] [Indexed: 11/26/2022] Open
Abstract
Purpose To report a case of recurrent conjunctival papillary sebaceous carcinoma that was successfully treated by a combination of surgical resection, intraoperative topical mitomycin C application, and cryotherapy. Observations A woman in her 80s developed a yellowish papillary tumor pedunculated from the surface of the upper palpebral tarsal conjunctiva in her left eye. She was histopathologically diagnosed as having sebaceous carcinoma by an excisional biopsy. We performed en bloc resection of the lateral one-third of the posterior lamella including the cutaneous margin of the upper eyelid as well as reconstruction of the defected portion by a switch-flap from the ipsilateral lower eyelid. Histopathologically, because the tumor was restricted to the epithelial region with minimal invasion into the tarsus, we diagnosed the patient to have conjunctival papillary sebaceous carcinoma. Nine months after the surgery, the tumor recurred and was resected and treated by intraoperative mitomycin C. Four months later, the tumor regrew at the resected margins and was treated by resection combined with mitomycin C and cryotherapy. After these combination treatments, the tumor did not recur for at least 1 year postoperatively. Conclusion and Importance Although sebaceous carcinoma usually originates from the meibomian gland cells or less frequently from the Zeis or Moll gland cells, it rarely occurs from bulbar or palpebral conjunctival cells. Because sebaceous carcinoma sometimes shows a pagetoid growth pattern, it can recur even after en bloc resection with a negative study for tumor cells at the surgical margins. The recurrent sebaceous carcinoma cells showed an intraepithelial growth pattern. Considering this superficial growth property, it may be effective to apply intraoperative mitomycin C and cryotherapy treatment combined with surgical resection to reduce the possibility of recurrence of presumed conjunctival papillary sebaceous carcinoma, although mitomycin C alone seems to be insufficient as an adjunctive treatment.
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Affiliation(s)
- Natsuki Monai
- Department of Ophthalmology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Reiko Tanabu
- Department of Ophthalmology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Takayuki Gonome
- Department of Ophthalmology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Katsunori Yokoi
- Department of Plastic and Reconstructive Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Satoshi Urushidate
- Department of Plastic and Reconstructive Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Satoko Morohashi
- Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hideaki Hirai
- Department of Anatomic Pathology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Akira Kurose
- Department of Anatomic Pathology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Mitsuru Nakazawa
- Department of Ophthalmology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
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34
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Acosta AM, Al Rasheed MRH, Xu H, Salibay C, Pins MR. Sebaceous carcinoma of the breast in a patient with a pathogenic BRCA2 (886delGT) mutation - focus on histopathologic and immunohistochemical features. APMIS 2018; 126:353-356. [PMID: 29575201 DOI: 10.1111/apm.12826] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Accepted: 01/08/2018] [Indexed: 11/27/2022]
Abstract
Sebaceous carcinoma of the breast (SCB) is a rare variant of ductal carcinoma arising within the mammary gland and containing at least 50% of malignant cells with sebaceous differentiation. Only 11 cases that adjust to the criteria delineated in the WHO classification have been published in the English literature, to the best of our knowledge. Here, we present the first SCB arising in the context of a deleterious BRCA2 mutation, focusing on the histopathologic and immunohistochemical features of this exceedingly rare tumor.
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Affiliation(s)
- Andres M Acosta
- Department of Pathology, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Haoliang Xu
- Department of Pathology, University of Illinois at Chicago, Chicago, IL, USA
| | - Christine Salibay
- Department of Pathology, University of Illinois at Chicago, Chicago, IL, USA
| | - Michael R Pins
- Department of Pathology, Chicago Medical School, North Chicago, IL, USA.,Department of Pathology, Lutheran General Hospital, Park Ridge, IL, USA
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35
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Abstract
PURPOSE OF REVIEW Recent advances in the treatment of eyelid tumors have centered on the excision, evaluation of margins, role of sentinel lymph node biopsy, and adjunctive/adjuvant systemic and radiation therapy. The purpose of this review is to elaborate on these advances. RECENT FINDINGS Mohs excision of basal cell carcinoma and squamous cell carcinoma continues to provide the greatest success in complete excision of the cancer, especially in those cases of high-risk disease including medial canthal location and recurrent disease. Sentinel lymph node biopsy has proven useful in the assessment of early regional metastasis in sebaceous cell carcinoma, melanoma, and Merkel cell carcinoma. The pathologic finding of perineural invasion is a high-risk feature in all periocular cancers, and adjuvant therapy should be considered. Targeted therapy shows great potential in situations that are not amenable to complete excision without sacrificing the globe. Identification of high- and low-risk features in eyelid cancers allows a stratified approach to treatment. While high-risk features may require adjuvant therapy, larger margins, and sentinel lymph node biopsy, low-risk features may allow topical therapy to adequately address the condition. Monoclonal antibodies and small molecule inhibitors show great promise in the treatment of extensive disease.
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Affiliation(s)
- Richard C Allen
- Section of Ophthalmology, Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1445, Houston, TX, 77030, USA.
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36
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Bladen JC, Moosajee M, Tracey-White D, Beaconsfield M, O'Toole EA, Philpott MP. Analysis of hedgehog signaling in periocular sebaceous carcinoma. Graefes Arch Clin Exp Ophthalmol 2018; 256:853-860. [PMID: 29423837 PMCID: PMC5856882 DOI: 10.1007/s00417-018-3900-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 10/14/2017] [Accepted: 01/05/2018] [Indexed: 12/27/2022] Open
Abstract
PURPOSE Sebaceous carcinoma (SC) is a clinical masquerader of benign conditions resulting in significant eye morbidity, sometimes leading to extensive surgical treatment including exenteration, and even mortality. Little is known about the genetic or molecular basis of SC. This study identifies the involvement of Hedgehog (Hh) signaling in periocular SC. METHODS Fifteen patients with periocular SC patients were compared to 15 patients with eyelid nodular basal cell carcinoma (nBCC; a known Hh tumor), alongside four normal individuals as a control for physiological Hh expression. Expression of Patched 1 (PTCH1), Smoothened (SMO), and glioma-associated zinc transcription factors (Gli1 and Gli2) were assessed in histological sections using immunohistochemistry and immunofluorescence (IF) techniques. Antibody specificity was verified using Western-blot analysis of a Gli1 over-expressed cancer cell line, LNCaP-Gli1. Semi-quantification compared tumors and control tissue using IF analysis by ImageJ software. RESULTS Expression of the Hh pathway was observed in SC for all four major components of the pathway. PTCH1, SMO, and Gli2 were more significantly upregulated in SC (P < 0.01) compared to nBCC. Stromal expression of PTCH1 and Gli2 was observed in SC (P < 0.01). In contrast, stromal expression of these proteins in nBCC was similar or down-regulated compared to physiological Hh controls. CONCLUSIONS The Hh signaling pathway is significantly more upregulated in periocular SC compared to nBCC, a known aberrant Hh pathway tumor. Furthermore, the stroma of the SC demonstrated Hh upregulation, in particular Gli2, compared to nBCC. Targeting of this pathway may be a potential treatment strategy for SC.
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Affiliation(s)
- John C Bladen
- Eyelid Oncology, Moorfields Eye Hospital, London, UK.
- Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts & London School of Medicine, 4 Newark St, London, E1 2AT, UK.
| | - Mariya Moosajee
- Department of Ocular Biology and Therapeutics, UCL Institute of Ophthalmology, London, UK
| | - Dhani Tracey-White
- Department of Ocular Biology and Therapeutics, UCL Institute of Ophthalmology, London, UK
| | | | - Edel A O'Toole
- Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts & London School of Medicine, 4 Newark St, London, E1 2AT, UK
| | - Michael P Philpott
- Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts & London School of Medicine, 4 Newark St, London, E1 2AT, UK
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Huang X, Lin Y, Wu H, Zhou Y, Mao F, Wang C, Peng L, Cao X, Chen C, Sun Q. Sebaceous carcinoma of the breast nipple: a case report and literature review. Int J Clin Exp Pathol 2017; 10:10571-10575. [PMID: 31966398 PMCID: PMC6965805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 09/22/2017] [Indexed: 06/10/2023]
Abstract
Sebaceous carcinoma (SC) of the breast nipple is a rare malignant tumor, and only five cases, including the present one, have been reported in the English-language literature. The present report describes a case of SC of the breast nipple in a 51-year old Chinese woman. The lesion presented a gradually enlarging nodule in the right breast nipple, with transparent yellow exudate overflowing from the cutaneous lesions. The histopathological results revealed that the tumor cells were arranged in nests consisting of sebocytes with vacuolated or multivesicular/foamy cytoplasm and atypical nuclei, accompanied with definite foci of keratinization and keratin pearls. Complete resection of the lesion and SLNB were accomplished, and no recurrence was observed during the follow-up. This is the first case of SC in the nipple-areolar complex diagnosed in Peking Union Medical College Hospital in Beijing of China for the period from 1995 to 2016, and therefore, it contributes to a better understanding of its clinicopathological characteristics and improved recommendations for diagnosis and treatment it contributes to the recommendations for diagnosis and treatment.
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Affiliation(s)
- Xin Huang
- Department of Breast Surgery, Peking Union Medical College HospitalBeijing, China
| | - Yan Lin
- Department of Breast Surgery, Peking Union Medical College HospitalBeijing, China
| | - Huanwen Wu
- Department of Pathology, Peking Union Medical College HospitalBeijing, China
| | - Yidong Zhou
- Department of Breast Surgery, Peking Union Medical College HospitalBeijing, China
| | - Feng Mao
- Department of Breast Surgery, Peking Union Medical College HospitalBeijing, China
| | - Changjun Wang
- Department of Breast Surgery, Peking Union Medical College HospitalBeijing, China
| | - Li Peng
- Department of Breast Surgery, Peking Union Medical College HospitalBeijing, China
| | - Xi Cao
- Department of Breast Surgery, Peking Union Medical College HospitalBeijing, China
| | - Chang Chen
- Department of Breast Surgery, Peking Union Medical College HospitalBeijing, China
| | - Qiang Sun
- Department of Breast Surgery, Peking Union Medical College HospitalBeijing, China
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Abstract
Sebaceous skin tumors are classified into sebaceous adenoma, sebaceoma, and sebaceous carcinoma. An additional group of cystic sebaceous tumors indicate the Muir-Torre syndrome (MTS). Cystic sebaceous tumors are considered as morphologic variants of the 3 main categories. Multilineage adnexal tumors with partly sebaceous differentiation may pose a challenge to categorize. Sebaceous hyperplasia and nevus sebaceus are not considered as true sebaceous tumor entities. Recently, attention has been drawn to morphologic clues of sebaceous differentiation. Immunohistochemistry using the mismatch repair proteins and/or genetic microsatellite instability testing should be performed on sebaceous neoplasms to diagnose MTS as early as possible.
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Affiliation(s)
- Katharina Flux
- Department of Dermatology, University of Heidelberg, Im Neuenheimer Feld 440, 69120 Heidelberg, Germany; Labor für Dermatohistologie und Oralpathologie, Bayerstrasse 69, 80335 München, Munich, Germany.
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Ishiguro Y, Homma S, Yoshida T, Ohno Y, Ichikawa N, Kawamura H, Hata H, Kase S, Ishida S, Okada-Kanno H, Hatanaka KC, Taketomi A. Usefulness of PET/CT for early detection of internal malignancies in patients with Muir-Torre syndrome: report of two cases. Surg Case Rep 2017; 3:71. [PMID: 28537014 PMCID: PMC5442035 DOI: 10.1186/s40792-017-0346-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 05/11/2017] [Indexed: 11/11/2022] Open
Abstract
Background Muir–Torre syndrome (MTS) is a rare autosomal dominant genodermatosis caused by mutations in mismatch repair genes. It is characterized by the presence of at least one sebaceous skin tumor associated with internal malignancies. Whether positron emission tomography/computed tomography (PET/CT) is useful for the detection of malignancies in patients with MTS has not been determined. We herein report two cases in which PET/CT was useful for the diagnosis and follow-up of internal malignancies in patients with MTS. Case presentation In case 1, a 57-year-old woman underwent excision of a sebaceous carcinoma on the left upper eyelid. She underwent follow-up PET/CT once yearly thereafter. Forty-two months after the eyelid surgery, PET/CT showed intense tracer uptake in the right lower abdomen. An ascending colon tumor was identified, and examination of a biopsy specimen showed adenocarcinoma. In case 2, a 77-year-old man presented for evaluation of three continuous papules with telangiectasia on his right cheek. Examination of a skin biopsy specimen of the cheek papule revealed a sebaceous carcinoma. He underwent PET/CT to detect other malignancies. PET/CT showed intense tracer uptake in the sigmoid colon. A sigmoid colon tumor was identified, and examination of a biopsy specimen showed adenocarcinoma. Both patients underwent resection of their tumors, and both were still free of recurrence of the sebaceous and colon carcinomas at the time of this writing. Conclusion PET/CT is a reliable imaging modality for the detection of internal malignancies and is useful for the diagnosis and follow-up of MTS.
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Affiliation(s)
- Yui Ishiguro
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Shigenori Homma
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan.
| | - Tadashi Yoshida
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Yosuke Ohno
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Nobuki Ichikawa
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Hideki Kawamura
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Hiroo Hata
- Department of Dermatology, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Satoru Kase
- Department of Ophthalmology, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Susumu Ishida
- Department of Ophthalmology, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Hiromi Okada-Kanno
- Department of Surgical Pathology, Hokkaido University Hospital, North 14, West 5, Kita-Ku, Sapporo, Hokkaido, 060-8648, Japan
| | - Kanako C Hatanaka
- Department of Surgical Pathology, Hokkaido University Hospital, North 14, West 5, Kita-Ku, Sapporo, Hokkaido, 060-8648, Japan
| | - Akinobu Taketomi
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
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Vasudevan G, Bishnu A, Singh BMK, Singh VK. Mucoepidermoid Carcinoma of Salivary Gland: Limitations and Pitfalls on FNA. J Clin Diagn Res 2017; 11:ER04-ER06. [PMID: 28658793 DOI: 10.7860/jcdr/2017/25341.9941] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Accepted: 02/05/2017] [Indexed: 11/24/2022]
Abstract
Mucoepidermoid Carcinoma (MEC) is the most common malignant neoplasm of salivary gland origin. However, its morphologic heterogeneity poses difficulty in interpretation. In the present series we discuss the morphologic features of MEC, limitations and pitfalls in its diagnosis on Fine Needle Aspiration Cytology (FNAC). Fourteen cases of suspected MEC were evaluated cytologically followed by histopathological examination for confirmation. A definite cytological diagnosis was rendered in nine cases; three of the remaining five were underdiagnosed as abscess, pleomorphic adenoma and mucus cyst. Of the remaining two cases, one case each of sebaceous carcinoma and sialadenitis was mislabeled as MEC on cytology. A satisfactory aspirate composed of intermediate cells, mucin secreting cells and squamous cells in a mucinous background may not be obtained in all cases of low grade MEC. High grade MEC can be classified as squamous cell carcinoma. Hence, awareness of confounding factors with clinicopathologic correlation and judicious use of frozen section can help in minimizing errors.
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Affiliation(s)
- Geetha Vasudevan
- Additional Professor, Department of Pathology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - Arijit Bishnu
- Assistant Professor, Department of Pathology, Melaka Manipal Medical College, Manipal University, Manipal, Karnataka, India
| | - Brij Mohan Kumar Singh
- Assistant Professor, Department of Immunohematology and Blood Transfusion, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - Varun Kumar Singh
- Junior Resident, Department of Pathology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
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41
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Yamamoto Y, Nakamura T, Koyama H, Kanai T, Moritani S, Ichihara S. Sebaceous carcinoma of the breast: a case report. Surg Case Rep 2017; 3:38. [PMID: 28233285 PMCID: PMC5323417 DOI: 10.1186/s40792-017-0312-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 02/18/2017] [Indexed: 12/02/2022] Open
Abstract
Background Sebaceous carcinoma of the breast is a distinct variant of invasive ductal carcinoma. It is rare and only several cases have been reported. Case presentation An 80-year-old woman noted bloody discharge from her left nipple and palpated a lump in her left breast. Ultrasonography revealed a 19-mm mass in the left breast. Fine-needle aspiration suggested invasive ductal carcinoma. Partial mastectomy and sentinel lymph node biopsy were performed. On histological examination, the tumor revealed solid growth of small, round uniform cells with clear cytoplasm, partially intermingled with vacuolated cells indicative of sebaceous differentiation. The tumor cells contained abundant Sudan Black B-positive lipid droplets in the cytoplasm, and they were immunohistochemically positive for adipophilin. They were negative for estrogen receptor, progesterone receptor, and androgen receptor; positive for cytokeratin 7 and Ber-EP4; and partially positive for epithelial membrane antigen. Based on these findings, the patient was diagnosed with sebaceous carcinoma of the breast. Conclusions We diagnosed a rare case of sebaceous carcinoma of the breast.
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Affiliation(s)
- Yuta Yamamoto
- Department of Surgery, Suwa Red Cross Hospital, Suwa, Japan.,Present address: Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | | | - Hiroshi Koyama
- Department of Surgery, Suwa Red Cross Hospital, Suwa, Japan.,Koyama Clinic, Suwa, Japan
| | - Toshiharu Kanai
- Department of Surgery, Suwa Red Cross Hospital, Suwa, Japan.,Present address: Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Suzuko Moritani
- Department of Pathology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.,Present address: Department of Pathology, Shiga University of Medical Science, Otsu, Japan
| | - Shu Ichihara
- Department of Pathology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
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42
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Neelakantan IV, Di Palma S, Smith CET, McCoombe A. Parotid Sebaceous Carcinoma in Patient with Muir Torre Syndrome, Caused by MSH2 Mutation. Head Neck Pathol 2016; 10:354-61. [PMID: 26577210 PMCID: PMC4972744 DOI: 10.1007/s12105-015-0670-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Accepted: 11/06/2015] [Indexed: 02/04/2023]
Abstract
Sebaceous carcinoma of parotid gland are extremely rare with only 29 cases reported so far. The development of parotid sebaceous carcinoma in association with mutation in the mismatch repair gene that causes Muir Torre Syndrome (MTS), a subset of Lynch Syndrome, is still unclear. This study describes such a case and reviews the literature to see if an association between parotid sebaceous carcinoma and multiple visceral malignancies seen in Lynch Syndrome has ever been described. MTS represents a small subset of the Hereditary Non Polyposis Colorectal Carcinoma family, thought to be a subtype of Lynch Syndrome, where patients are prone to develop multiple visceral cancers involving gastrointestinal and genitourinary tract along with sebaceous and non-sebaceous tumours of the skin. MTS is a rare hereditary, autosomal dominant cancer syndrome caused by Microsatellite Instability and defect in DNA mismatch repair protein. The germline mutation involves mostly hMSH2 and hMLH1 genes. In MTS the skin of the head and neck area with the periocular region in particular, is affected but sebaceous carcinomas of the parotid associated with visceral malignancies has not yet been reported in literature. Here we report an index case of sebaceous carcinoma of parotid gland in a patient with MTS.
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Affiliation(s)
| | - Silvana Di Palma
- Department of Histopathology, Royal Surrey County Hospital, Egerton Road, Guildford, GU2 8DY UK
| | - C. E. T. Smith
- Department of Histopathology, Frimley Park Hospital, Camberley, Surrey UK
| | - A. McCoombe
- Department of ENT, Frimley Park Hospital, Camberley, Surrey UK
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43
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Marnouche EA, Maghous A, Kadiri S, Berhili S, Touil A, Kettani F, Majjaoui S, Elkacemi H, Kebdani T, Benjaafar N. Sebaceous carcinoma of the parotid gland: a case report and review of the literature. J Med Case Rep 2016; 10:174. [PMID: 27295996 PMCID: PMC4906575 DOI: 10.1186/s13256-016-0946-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 05/10/2016] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Sebaceous carcinoma is a rare malignancy primarily with aggressive growth affecting the cutaneous tissues of the periocular region. Sebaceous carcinoma of the parotid gland is exceedingly rare, with only 32 cases reported in the literature. Our case brings this total to 33. CASE PRESENTATION We present a case of a 57-year-old Moroccan woman with a firm, painless, slowly enlarging swelling at her left parotid area, with normal overlying skin and no palpable neck nodes. Parotidectomy with facial nerve preservation was performed, and microscopic examination showed sebaceous carcinoma. Then, she underwent adjuvant radiotherapy. With a follow up of 20 months, head and neck computed tomography revealed no recurrence. CONCLUSIONS The optimal treatment is unclear. With more cases reported, clinicopathological characteristics and histogenesis are increasingly understood. Therefore the treatment for this rare tumor continues to evolve.
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Affiliation(s)
- El Amin Marnouche
- Department of Radiotherapy, National Institute of Oncology, Rabat, Morocco.
| | - Abdelhak Maghous
- Department of Radiotherapy, National Institute of Oncology, Rabat, Morocco
| | - Selma Kadiri
- Department of Radiotherapy, National Institute of Oncology, Rabat, Morocco
| | - Soufiane Berhili
- Department of Radiotherapy, National Institute of Oncology, Rabat, Morocco
| | - Asmae Touil
- Department of Radiotherapy, National Institute of Oncology, Rabat, Morocco
| | - Fouad Kettani
- United Nations Center of Cytopathology, Rabat, Morocco
| | - Sanaa Majjaoui
- Department of Radiotherapy, National Institute of Oncology, Rabat, Morocco
| | - Hanane Elkacemi
- Department of Radiotherapy, National Institute of Oncology, Rabat, Morocco
| | - Tayeb Kebdani
- Department of Radiotherapy, National Institute of Oncology, Rabat, Morocco
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Shima T, Yamamoto Y, Okuhira H, Mikita N, Furukawa F. A Patient with Refractory Psoriasis Who Developed Sebaceous Carcinoma on the Neck during Cyclosporine Therapy and Showed Rapid Progression. Case Rep Dermatol 2016; 8:136-41. [PMID: 27462222 PMCID: PMC4943301 DOI: 10.1159/000446342] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 04/20/2016] [Indexed: 11/19/2022] Open
Abstract
We report a patient who developed sebaceous carcinoma on the neck during therapy with immunosuppressive agents (cyclosporine, corticosteroid, methotrexate) for refractory psoriasis vulgaris, which showed rapid enlargement, leading to a fatal outcome. Multiple-organ metastases were detected. Weekly carboplatin + paclitaxel therapy resulted in the disappearance of tumor cells, but the patient died of febrile neutropenia. The development of sebaceous carcinoma is rare among psoriasis patients receiving immunosuppressive agents including cyclosporine.
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Affiliation(s)
- Tomoko Shima
- Department of Dermatology, Wakayama Medical University, Wakayama, Japan
| | - Yuki Yamamoto
- Department of Dermatology, Wakayama Medical University, Wakayama, Japan
| | - Hisako Okuhira
- Department of Dermatology, Wakayama Medical University, Wakayama, Japan
| | - Naoya Mikita
- Department of Dermatology, Wakayama Medical University, Wakayama, Japan
| | - Fukumi Furukawa
- Department of Dermatology, Wakayama Medical University, Wakayama, Japan
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Abstract
Background Sebaceous glands contribute significantly to the barrier functions of the skin. However, little is known about their homeostasis and tumorigenesis. Recently, increased expression of stem cell marker Lrig1 has been reported in sebaceous carcinoma-like tumors of K14ΔNLef1 transgenic mice. In this study, we analyzed the Lrig1 expression in human sebaceous tumors. Methods Twenty-eight formalin-fixed paraffin-embedded sebaceous tumor specimens (7 sebaceous hyperplasias, 7 sebaceous adenomas, 10 sebaceomas and 4 sebaceous carcinomas) were stained with anti-Lrig1, anti-CD44v3 and anti-Ki67 antibody. Results Four (100%) sebaceous carcinomas, 8 (80%) sebaceomas, 3 (43%) sebaceous adenomas and no sebaceous hyperplasia showed Lrig1 overexpression. Discussion and Conclusion Lrig1 is a known tumor suppressor gene and is usually considered to be an indicator of poorly aggressive tumors. In human sebaceous tumors, the stronger Lrig1 staining in sebaceous carcinoma compared to other sebaceous tumors might be a feature of an advanced stage in tumorigenesis and a bad prognosis. In our study, 100% of sebaceous carcinomas revealed Lrig1 overexpression. We propose that Lrig1 may be used as a possible new marker of poorly differentiated sebaceous carcinoma.
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Affiliation(s)
- Jöri Pünchera
- Department of Dermatology, University Hospital of Geneva, Geneva, Switzerland
| | - Laurent Barnes
- Department of Dermatology, University Hospital of Geneva, Geneva, Switzerland
| | - Gürkan Kaya
- Department of Dermatology, University Hospital of Geneva, Geneva, Switzerland
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46
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Tulpule S, Ibrahim H, Osman M, Zafar S, Kanta R, Shypula G, Islam MA, Sen S, Yousif A. Muir-Torre Syndrome Presenting as Sebaceous Adenocarcinoma and Invasive MSH6-Positive Colorectal Adenocarcinoma. Case Rep Oncol 2016; 9:95-9. [PMID: 26933426 PMCID: PMC4772623 DOI: 10.1159/000443788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Muir-Torre syndrome (MTS) is a rare genodermatosis, diagnosed by the presence of sebaceous neoplasms along with an internal malignancy, most commonly colorectal carcinomas. MTS is most commonly caused by microsatellite instabilities of the hMLH1 and hMSH2 mismatch repair genes, and is rarely caused by mutations of the hMSH6 gene. We describe the case of a 56-year-old male who presented with an enlarging mass on his back as well as hematochezia. The back mass was excised, and pathology confirmed microsatellite instability in MSH2 and MSH6. Abdominal CT and colonoscopy confirmed the presence of synchronous masses in the cecum, ascending colon, and the transverse colon. He refused any further workup or treatment, only to return 8 months later complaining of hematochezia and discomfort due to an enlarging mass protruding from the rectum. After consenting to surgical intervention, he agreed to outpatient chemotherapy treatment. The presence of sebaceous neoplasms should raise suspicion for the possibility of an associated internal malignancy.
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Affiliation(s)
- Sunil Tulpule
- Department of Medicine, Raritan Bay Medical Center, Perth Amboy, N.J., USA
| | - Hiyam Ibrahim
- Department of Medicine, Raritan Bay Medical Center, Perth Amboy, N.J., USA
| | - Mohamed Osman
- Department of Medicine, Raritan Bay Medical Center, Perth Amboy, N.J., USA
| | - Shoaib Zafar
- Department of Medicine, Raritan Bay Medical Center, Perth Amboy, N.J., USA
| | - Romana Kanta
- Department of Medicine, Raritan Bay Medical Center, Perth Amboy, N.J., USA
| | - Gregory Shypula
- Department of Medicine, Raritan Bay Medical Center, Perth Amboy, N.J., USA
| | - Mohammed A Islam
- Department of Medicine, Raritan Bay Medical Center, Perth Amboy, N.J., USA
| | - Shuvendu Sen
- Department of Medicine, Raritan Bay Medical Center, Perth Amboy, N.J., USA
| | - Abdalla Yousif
- Department of Medicine, Raritan Bay Medical Center, Perth Amboy, N.J., USA
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Bell WR, Singh K, Rajan Kd A, Eberhart CG. Expression of p16 and p53 in Intraepithelial Periocular Sebaceous Carcinoma. Ocul Oncol Pathol 2015; 2:71-5. [PMID: 27171611 DOI: 10.1159/000439308] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 08/10/2015] [Indexed: 11/19/2022] Open
Abstract
PURPOSE Identifying intraepithelial sebaceous carcinoma cells in small periocular biopsies can be difficult, particularly in the conjunctiva. The goal of this study was to evaluate p53 and p16 immunohistochemistry as potential markers of intraepithelial sebaceous carcinoma. PROCEDURES A total of 25 tumors, including 4 recurrent lesions, were stained for p16 and p53, with intensity scored as negative, weak, moderate or strong. RESULTS Expression of p16 was detected in intraepithelial sebaceous carcinoma cells in 24 of the 25 cases (96%), with only 1 case showing weak immunoreactivity. Intraepithelial p53 immunoreactivity was present in 17 of 25 tumors (68%), but was weak in 3 cases. Expression levels remained relatively stable in primary and recurrent tumors, but varied in a few cases between intraepithelial and subepithelial sites. CONCLUSIONS Intraepithelial sebaceous carcinomas stained for p53 and p16 demonstrated moderate to strong immunoreactivity in 100% of cases for at least one of these proteins, suggesting that together they are useful markers for determining the extent of tumor spread. Of the two, p16 was immunoreactive in more cases than p53.
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Affiliation(s)
- W Robert Bell
- The Johns Hopkins University School of Medicine, Baltimore, Md., USA
| | - Kamaljeet Singh
- The Johns Hopkins University School of Medicine, Baltimore, Md., USA
| | - Anand Rajan Kd
- The Johns Hopkins University School of Medicine, Baltimore, Md., USA
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48
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Mahfoudhi M, Khamassi K. [ Sebaceous carcinoma of the parotid gland]. Pan Afr Med J 2015; 21:132. [PMID: 26327969 PMCID: PMC4546772 DOI: 10.11604/pamj.2015.21.132.7166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 06/15/2015] [Indexed: 12/03/2022] Open
Affiliation(s)
- Madiha Mahfoudhi
- Service de Médecine Interne A, Hôpital Charles Nicolle, Tunis, Tunisie
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Abstract
Background Primary sebaceous carcinoma of the parotid gland is extremely rare, and because of its rarity, clinicopathological characteristics and histogenesis are not fully understood. Methods Here, we report a patient who presented with a left infra-auricular painless mass. We present the histological features and discuss possible optimal treatments based on previous literature. Results The mass was suspected to be a myoepithelial tumor or possibly a pleomorphic adenoma. Initially, the mass was resected with preservation of the facial nerve, but this caused facial palsy. Because the histological examination showed a sebaceous carcinoma and a part of the mass could be remaining on the facial nerve, additional surgery was performed, and the facial nerve was reconstructed with cervical nerve. Follow-up after 7 months showed no sign of recurrence of metastasis. Conclusion We encountered a rare sebaceous carcinoma of the parotid gland. Additional surgery was performed because preoperative diagnosis was difficult.
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Kwon MJ, Shin HS, Nam ES, Cho SJ, Lee MJ, Lee S, Park HR. Comparison of HER2 gene amplification and KRAS alteration in eyelid sebaceous carcinomas with that in other eyelid tumors. Pathol Res Pract 2014; 211:349-55. [PMID: 25468813 DOI: 10.1016/j.prp.2014.10.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 10/01/2014] [Accepted: 10/22/2014] [Indexed: 02/07/2023]
Abstract
Eyelid sebaceous carcinoma (SC) represents a highly aggressive malignancy. Despite the poor prognosis, genetic alterations as potential molecular targets are not available. KRAS mutation and HER2 gene amplification may be candidates related to their genetic alterations. We examined the HER2 and KRAS alteration status in eyelid SCs and compared it with that in other eyelid tumors. The controversial topics of the human papillomavirus (HPV) and p16 expression were also investigated. HER2 amplification was determined by silver in situ hybridization, while immunohistochemistry was performed to study protein expressions in 14 SCs and controls, including 23 other eyelid malignancies and 14 benign tumors. Peptide nucleic acid-mediated PCR clamping and direct sequencing were used to detect KRAS mutations. HER2 protein overexpression was observed in 85.7% (12/14) of the SCs, of which two-thirds showed HER2 gene amplification. HER2 protein overexpression and HER2 amplification were found more frequently in eyelid SCs than in other eyelid tumors. All SCs harbored wild type KRAS genes. No HPV infections were identified in the SCs. Nevertheless, p16 overexpression was found in 71.4% (10/14) of SCs, irrespective of the status of HPV infection. Furthermore, p16 overexpression in eyelid SCs was also significantly higher than that in other eyelid tumors. HER2 protein overexpression, HER2 gene amplifications, and wild type KRAS genes are common in eyelid SCs. HER2 gene amplification may represent potential therapeutic targets for the treatment of eyelid SCs.
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Affiliation(s)
- Mi Jung Kwon
- Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 431-070, Gyeonggi-do, Republic of Korea
| | - Hyung Sik Shin
- Department of Pathology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, 445, Gil 1-dong, Gangdong-gu, Seoul 134-701, Republic of Korea
| | - Eun Sook Nam
- Department of Pathology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, 445, Gil 1-dong, Gangdong-gu, Seoul 134-701, Republic of Korea
| | - Seong Jin Cho
- Department of Pathology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, 445, Gil 1-dong, Gangdong-gu, Seoul 134-701, Republic of Korea
| | - Min Joung Lee
- Department of Ophthalmology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 431-070, Gyeonggi-do, Republic of Korea
| | - Samuel Lee
- Department of Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, 445, Gil 1-dong, Gangdong-gu, Seoul 134-701, Republic of Korea.
| | - Hye-Rim Park
- Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 431-070, Gyeonggi-do, Republic of Korea.
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