Sebaceous carcinoma of the oral cavity: a case report and review of the literature

Intraoral sebaceous carcinoma: A rare presentation on the tongue and review of the literature

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.

Sebaceous carcinoma of the lip: a case report and review of the literature

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.

Sebaceous carcinoma of the right palate: case report and literature review

Considering the low incidence rates of primary sebaceous carcinoma (SC) of extraorbital sites, let alone those occur in intraoral sites, clinicopathological characteristics and histogenesis are not fully understood. In the present case, a maxillary mass was presented and a low-grade malignant tumor was suspected according to the CT scans, preoperative FNA, and clinical conditions. Other carcinomas, including acinar cell carcinoma (ACC), basaloid cell carcinoma (BCC), SCC, mucoepidermoid carcinoma, and epithelial-myoepithelial carcinoma (EMC), were also considered before surgery. Due to the rare occurrence of SC and no preoperative suspects, a fresh sample was not kept. Sadly, thus cause those special stains (e.g., Oil Red O and Sudan IV) which form the primary basis for a diagnosis of SC in academic circles were missing. A comprehensive literature review identified only 10 cases of intraoral SC, of which the primary sites reported in the English literature were the buccal mucosa, mouth floor, upper labial mucosa, and tongue. Due to an absence of specific biomarkers and simulated characters, histochemistry and immunohistochemistry such as PAS, CK, EMA, p63, p53, S-100, calponin, CD117, Ki-67, a-SMA, and AR form the diagnostic standard of SC. Postoperative immunohistochemistry of our case showed S100(-), Ki-67(-), calponin(-), CD117(-), CK20(-), PAS(-), AR(+), CK(+), CK5/6(+), P53(+), P63(+), a-SMA (+). Thus the diagnosis of SC was finally made. Through discussing the findings of our case and reviewing literature, we present the histological features and discuss possible outstanding biomarkers of this neoplasm.

Impact of surgery and adjuvant treatment on the outcome of extraocular sebaceous carcinoma: a systematic review and individual patient's data analysis of 206 cases

BACKGROUND

Extraocular sebaceous carcinoma (EOSC) is an aggressive malignancy of the sebaceous gland. Surgery is considered the cornerstone of treatment, but there is lack of clarity about extent and adjuvant treatment.

METHODS

We conducted a systematic review and analysis of individual patient data of all published cases of EOSC to look into demography, pattern of care, importance of type of surgery, and other adjuvant treatment and survival outcome. A search of PubMed and Google Scholar was done with the key words sebaceous carcinoma, extraocular sebaceous carcinoma, and Muir-Torre syndrome till December 2017. The data were compiled in an Excel chart and analyzed using SPSS IBM software.

RESULTS

Data of 206 patients were retrieved. Median age at presentation was 65 years (range: 11-96 years). Surgery was performed in all except 13 patients. Of these 13, eight were deemed inoperable for extensive disease, and five had metastatic disease. Median PFS and OS for the entire cohort were 84 months (95% CI: 10-158 months) and 92 months (95% CI: 59-126 months). Univariate analysis revealed significantly poor survival for patients with a metastatic disease, regional nodal metastasis, and those with Mohs micrographic or incomplete surgery.

CONCLUSION

EOSC is a disease of elderly patients with good prognosis. Complete surgery with regional lymph node dissection is standard treatment. The role of adjuvant radiotherapy is debatable but can be considered in patients with incomplete surgery or high-risk factors.

Nasal Sebaceous Carcinoma: A Case Report and Review of the Literature

Sebaceous carcinoma arising from the nasal vestibule is exceedingly rare, with 3 cases previously reported. We have described the case of a 69-year-old man with an indolent exophytic growth on the medial aspect of his right nasal vestibule. Incisional biopsy demonstrated sebaceous carcinoma. The clinical and pathologic features, in addition to the surgical course and the postoperative outcome, are discussed. We also report our findings from a review of the reported data, focusing on the diagnosis and treatment of this rare skin malignancy.

Intraoral Sebaceous Carcinoma: Case Report of a Rare Tumor Emphasizing the Histopathological Differential Diagnosis

Background

Sebaceous carcinoma (SC) is an uncommon cutaneous malignancy, usually occurring predominantly in the eyelids and only occasionally involving the oral cavity. Sebaceous carcinoma (SC) is a rare malignancy. Only 10 cases of sebaceous carcinoma of the oral cavity have been reported so far.

Case Presentation

A 40-year-old female presented with a mass on the left side of the middle third of the face. Radiographic findings were inconclusive. Resection of the mass was consistent with the diagnosis of primary sebaceous carcinoma.

Conclusion

Intraoral sebaceous carcinoma is uncommon. Due to its varied clinical appearance and presence of a diverse histopathologic appearance, the diagnosis is quite often confounding and elusive. Hence, it is imperative to familiarize oneself about various aspects of this rare tumor for earlier diagnosis, to improve the chances of patient's survival.

Sebaceous Differentiation in Squamous Cell Carcinoma of the Larynx and Adjacent Pharynx: Case Report with Review and Discussion of the Literature

Among the variants of squamous cell carcinoma (SCC) of the head and neck arising in mucosal surfaces, examples with sebaceous differentiation are exceedingly rare. We present a new case of SCC with sebaceous differentiation, developing in the larynx of a 64 year-old male, cigarette smoker and alcohol drinker. The tumor extended transglottically, metastasized to cervical lymph nodes, and killed the patient after 12 months. Comparing this case with four previously reported cases of SCC with sebaceous differentiation, two arising in the larynx and the other two in the adjacent pharynx, all five patients mostly shared the following features: appearance of the tumor in the seventh decade of life, heavy tobacco smoking, alcohol intake in three, surgery as mainstay treatment, tumor size between 2 and 4.7 cm, and regional lymph node metastases in four of them. Out of the four patients with a follow up of 12 months, two died of disease, one was alive with disease, and only one was alive without disease. One patient was lost for follow up. In conclusion, mucosal SCC with sebaceous differentiation is a very rare variant of SCC that when arising in the larynx and anatomically adjacent parts of the pharynx behaves aggressively and bears a dismal prognosis. The recognition of new cases of this entity requires special awareness of its phenotypic features and may be important for further assessment of its behavior.

Parotid gland, an exceptional localization of sebaceous carcinoma: case report

BACKGROUND

Sebaceous carcinoma (SC) is a rare malignancy, occurring predominantly in eyelids. Till date, only 25 cases of sebaceous carcinoma (SC) of the parotid gland have been reported in world literature.

CASE PRESENTATION

A 33 year-old male presented with left sided laterocervical mass. Clinical examination showed enlargement of the left parotid gland, with cervical lymphadenopathy. No skin lesions were found. A resection of the gland was performed. Pathological findings were consistent with primary sebaceous carcinoma of the parotid gland.

CONCLUSION

Sebaceous carcinoma of the parotid gland is extremely uncommon. Clinical and radiological features are not specific. The aim of this report, is to describe histopathological, and immunohistochemical findings of this rare entity, and discuss differential diagnosis.

Intraoral sebaceous carcinoma metastatic to the lung and subcutis: Case report and discussion of the literature

BACKGROUND

Intraoral sebaceous carcinoma is a rare form of sebaceous carcinoma with only 9 published cases in the world literature to date. We present a 10th case of intraoral sebaceous carcinoma located in the anterior maxillary gingiva with metastases to the lung and subcutis and discuss 3 possible etiologies for this unique presentation.

METHODS

We analyze the clinical presentation, pathology, histology, and genetic testing for a single case study and review relevant literature.

RESULTS

The histologic findings of the lung tumor and surgical excisions of the tumors in the gingiva and subcutis suggest the gingiva is the primary site. There is no evidence for the genetic abnormalities consistent with Muir-Torre syndrome.

CONCLUSION

The histologic findings suggest the oral cavity is the most likely site of tumor origin. This is the first case of intraoral sebaceous carcinoma reported to arise in the gingiva as well as to spread to cutaneous sites.

Sebaceous carcinoma of the lip: Comparing normal lip and cheek anatomy with the imaging features of a rare cutaneous malignancy

Sebaceous carcinoma is a rare cutaneous malignancy, commonly affecting the eyelids. This case highlights a patient who presented with sebaceous carcinoma of the right upper lip with extensive involvement of the soft tissues of the head and neck. As part of the initial investigation, ultrasound was requested. This case demonstrates the ultrasound features of sebaceous carcinoma as well as revising the normal ultrasound anatomy of the upper lip and muscles of the cheek.

Sebaceous carcinoma of the maxillary gingival: First reported case involving the gingiva

Sebaceous carcinoma of the oral cavity is extremely rare. To date, only 9 cases of primary sebaceous carcinoma involving the oral cavity have been reported in the English literature, with the majority of cases occurring on the buccal mucosa. This report describes a case of sebaceous carcinoma involving the maxillary gingiva. To our knowledge this is the first reported case of sebaceous carcinoma of the gingiva.

My journey into the world of salivary gland sebaceous neoplasms

As part of this symposium honoring Leon Barnes, the authors were asked to present the case from which they learned the most. I chose a cystic sebaceous lymphadenoma (SL) as my case presentation. This paper presents this unusual case, as well as several additional sebaceous tumors that came across my desk the first few years I was in practice. These interesting cases led me to thoroughly review the literature on sebaceous tumors of the salivary glands, resulting in several publications, the largest series of sebaceous tumors published at this time as well as a careful review of all cases in the literature. The author will also review the current and previous literature on the five types of salivary gland sebaceous tumors: sebaceous adenoma, SL (and non-sebaceous lymphadenoma), sebaceous carcinoma, sebaceous lymphadenocarcinoma, and sebaceous differentiation in other types of salivary gland lesions.