Sebaceous Carcinoma

 

Epidemiology:

    • Older adults

 

Common sites:

    • Head and neck
    • periocular (meibomian gland)

 

Gross features:

    • nodule
      • may be ulcerated
    • eyelid:
      • discrete nodule or diffuse thickening of eyelid
      • may spread into lacrimal drainage system and nasopharynx
      • may extend into lacrimal gland ductules and lacrimal gland

 

Histologic features:

    • may be attached to overlying epidermis
    • irregular lobules or diffuse infiltrating pattern
    • spectrum of sebaceous differentiation:
      • predominantly basaloid cells
      • numerous multi-vacuolated sebaceous cells
    • nucleoli usually
    • mitoses frequent usually
    • infiltration usually
      • perineural
      • LVI
    • necrosis usually
    • nuclear pleomorphism usually
    • may mimic other malignancies including BCC
    • Pagetoid spread often in periocular variants
      • May mimic Bowenoid actinic keratosis

 

Immunophenotype:

Marker:

Sensitivity:

Specificity:

 CK

 

 

EMA

 

 

S-100 (neg)

 

 

CEA (neg)

 

 

 

Molecular features:

    •  

 

Other features:

    • second most common malignancy of eyelid
    • high metastatic potential and mortality

 

References:

    • Sternberg 2004
    • Essentials of AP 2006