Extra-Ocular Sebaceous Carcinoma Unveiled: A Case Study of Dermal Challenges in an Elderly African American Patient

TL;DR

This case study describes a rare sebaceous carcinoma in an elderly African American patient that appeared on the upper back, highlighting the diagnostic challenges of this aggressive tumor.

Contribution

The paper presents an atypical extraocular case of sebaceous carcinoma with a delayed diagnosis and unique clinical features.

Findings

The tumor was initially misdiagnosed as a benign sebaceous adenoma but later confirmed as sebaceous carcinoma.

The lesion showed aggressive features like prominent mitosis and infiltrative growth after surgical excision.

Clear surgical margins were achieved, but further oncology follow-up was recommended due to the tumor's rarity and aggressiveness.

Abstract

Sebaceous carcinoma is a rare malignant tumor of the sebaceous glands that most commonly presents in the periocular area. Uncommon extraocular manifestations are occasionally observed, often limited to the head or neck but can occur wherever sebaceous glands are found. There are increasing cases of sebaceous carcinoma in the United States which continue to pose ongoing diagnostic challenges. We present a patient with a 5.5 x 4 x 2 cm gradually growing necrotic and fungating upper back mass, present for one year. This lesion was initially diagnosed as an excoriated sebaceous adenoma, microscopically showing well-formed organoid structures and no irregular infiltration into the dermis, but was later confirmed as sebaceous carcinoma, demonstrating prominent mitosis and infiltrative growth pattern, following wide surgical excision. Margins were clear following the surgery with no signs of recurrence but further treatment recommendations included follow-up with oncology due to the rarity and aggressive nature of this tumor. This case serves to present an atypical presentation of a rare malignancy that has an increased occurrence rate for unknown reasons.

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