Sebaceoma: Un tumor infrecuente en el conducto auditivo externo / Sebaceoma: an unusual tumor in the external auditory canal

El sebaceoma es un tumor cutáneo poco frecuente que presenta diferenciación sebácea, y se localiza en piel de cabeza y cuello. Puede asociarse con la presencia de tumores malignos, asociación conocida como síndrome de Muir-Torre, por lo que ante su diagnóstico se deben descartar. Su localización en la piel del conducto auditivo externo es muy infrecuente. Presentamos nuestra experiencia en el manejo de esta patología en un varón de 78 años de edad que presentaba una lesión nodular sólida en el conducto auditivo externo izquierdo con pérdida de audición y otorrea como síntomas asociados. Se recomienda la exéresis completa de la lesión, como tratamiento de elección con fines tanto diagnósticos como terapéuticos.

Sebaceoma is a rare benign cutaneous tumor with sebaceous differentiation and it is typically located on the skin of the head and neck. This pathology made appear in association with malignant tumors (known as Muir-Torre syndrome) and must be ruled out. The location in the external auditory canal is very unusual. We present our experience in managing this pathology in a 78-year-old man who complains of hearing loss and otorrhea and presents a solid nodule in the left external auditory canal. Complete surgical removal was performed, as the choice treatment for diagnosis and therapeutic care.

Sebaceoma: hallazgos dermatoscópicos a propósito de dos casos / Sebaceoma: dermatoscopic findings at purpose of two cases

El sebaceoma es una neoplasia sebácea benigna inusual, que inicialmente se denominaba epitelioma sebáceo, lo que generaba confusión respecto a su biología tumoral, dado que histopatológicamente no presenta diferenciación suficiente como el adenoma sebáceo y tampoco es tan indeferenciado como el carcinoma sebáceo. Su diagnóstico precoz tiene gran relevancia, dado que, junto con el adenoma sebáceo y el carcinoma sebáceo, tienen una asociación directa con el síndrome de Muirr-Torre y, por lo tanto, con el desarrollo de cáncer de colon, endometrio, entre otros. En este punto, el uso de la dermatoscopia es muy importante. Considerando los pocos reportes en la literatura sobre la dermatoscopia en sebaceomas, presentamos dos casos clínicos en adultos, donde se destaca la presencia de estructuras amarillas homogéneas y vasos en corona o arboriformes.

Sebaceoma is an unusual benign sebaceous neoplasm, initially known as sebaceous epithelioma, which generated confusion regarding its tumor biology, given that it is histopathologically less differentiated than sebaceous adenoma, but with a higher differentiation than sebaceous carcinoma. Early diagnosis becomes relevant, given that together with sebaceous adenoma and sebaceous carcinoma, there is a direct association with Muirr-Torre syndrome and therefore the development of colon and endometrial cancer, among others. Because of this, the use of dermatoscopy becomes very important. Given the few reports in the literature on dermatoscopy in sebaceomas, we present two clinical cases, where the presence of homogeneous yellow structures and crown or arboriform vessels stands out.

Sebaceoma on the scalp simulating a malignant pigmented neoplasia

Abstract The correct identification of pigmented nodular lesions of the scalp is often challenging. Despite the importance of clinical patterns and dermoscopy, important adjuvant tools that are usually helpful, their interpretation sometimes is not clear-cut. Here, the authors discuss a case of sebaceoma mimicking a malignant pigmented neoplasia, with conclusive histopathology.

Caracterização anatomopatológica e imuno-histoquímica dos tumores das glândulas cutâneas em cães / Anatomopathological and immunohistochemical characterization of skin gland tumors in dogs

O presente estudo objetivou caracterizar os aspectos anatomopatológicos e imuno-histoquímicos dos tumores das glândulas cutâneas em cães. A caracterização morfológica seguiu a classificação atualizada da Organização Mundial de Saúde. Para a caracterização imuno-histoquímica, utilizaram-se anticorpos monoclonais primários anti-citoqueratina 14 (CK14), vimentina, p63, calponina, EGFR e Ki-67. Dos animais examinados, 66,67% (18/27) eram machos e 33,33% (9/27) fêmeas, 21 tinham raça definida e seis eram sem raça definida (SRD), com idade variando entre sete e 15 anos. Dos tumores caracterizados, 40,74% eram hepatoides (11/27), 29,63% sebáceos (8/27), 25,92% apócrinos (7/27) e 3,70% meibômio (1/27). Os tumores malignos representaram 55,56%, e os benignos 44,44%. Com esses resultados, foi possível demonstrar que os tumores das glândulas cutâneas em cães são frequentes, sem predileção por raça, sexo e com idade superior ou igual a sete anos. Os anticorpos CK 14, p63, vimentina e EGFR foram imunoexpressos nas células basais, células de diferenciação sebácea dos tumores hepatoides e de meibômio e células mioepiteliais. Entretanto, a vimentina e o EGFR não demonstraram imunomarcação para os tumores sebáceos. A calponina foi um bom marcador para as células mioepiteliais. O índice de Ki-67 foi mais acentuado nos tumores malignos em relação aos benignos. No entanto, estudos futuros utilizando maior número de casos se fazem necessários.(AU)

The present study aimed to characterize the anatomopathological and immunohistochemical aspects of cutaneous glandular tumors in dogs. Tumours were diagnosed according to the WHO criteria for canine skin neoplasms. For the immunohistochemical characterization, the primary monoclonal antibodies anti-cytokeratin 14 (CK14), vimentin, p63, calponin, EGFR and Ki-67 were used. Males were 66.67% (18/27) and females 33.33% (9/27), 21 had a defined race and 6 were mixed breed, with ages varying from 7 to 15 years. The tumors characterized were 40.74% hepatoid (11/27), 29.63% sebaceous (8/27), 25.92% apocrine (7/27) and 3.70% Meibômio (1/27). Malignant tumors accounted for 55.56% and benign tumors 44.44%. With these results it was possible to demonstrate that tumors of cutaneous glands in dogs are frequent, with no predilection for race, sex and with an age ≥ seven years. The CK 14 antibodies, p63, vimentin, and EGFR were imunoexpressed in the basal cells of the sebaceous cell differentiation and Meibomian hepatoides tumors and myoepithelial to cells. However, vimentin and EGFR did not demonstrate immunostaining for sebaceous tumors. Calponin was a good marker for myoepithelial cells. The Ki-67 index was more pronounced in malignant tumors compared to benign tumors. However, more studies are needed mainly using a higher number of tumors.(AU)

Carcinoma sebáceo extraocular, reporte de un caso / Extraocular sebaceous carcinoma, case report

RESUMEN El carcinoma sebáceo es una neoplasia anexial poco común que puede originarse en cualquier lugar del cuerpo donde existan glándulas sebáceas, siendo la principal ubicación la cabeza y el cuello, existiendo la presentación ocular y extraocular. Alcanza entre 0,2% a 4,6% de todas las neoplasias cutáneas malignas, con mayor incidencia en los adultos mayores caucásicos. La presentación clínica habitual corresponde a un nódulo duro o quístico subcutáneo eritematoso o amarillento, indoloro, de crecimiento acelerado. Sin embargo, puede manifestarse como una amplia gama de lesiones cutáneas, lo que, agregado a su baja incidencia, sea altamente subdiagnosticado. Se presenta el caso de un paciente de 64 años con tumor exofítico malar izquierdo con ulceraciones y áreas de necrosis en la superficie, sin compromiso de párpado inferior, de agudeza visual ni motilidad ocular. Se realiza resección del tumor, cuya biopsia definitiva confirma diagnóstico de carcinoma sebáceo extraocular.

ABSTRACT Sebaceous carcinoma is a rare anexal neoplasm that can develop on any part of the body containing sebaceous glands, but nearly the 70% of sebaceous carcinoma occur on the head and neck, being two ways of presentation, ocular and extraocular. It represents 0.2-4.6 % of all malignant neoplastic cutaneous lesions, whit a peak incidence in the eighth decades of life, in caucasian people. Typical clinical presentation of sebaceous carcinoma is a painless, firm or cystic subcutaneous nodule described as pink to red-yellow, however clinical features can be quite varied, which added to its low incidence leads to the diagnosis is often delayed for months to years. We present the case of a 64 years old patient whit an exofitic malar tumor ulcerated and necrotic in the surface, without compromising the lower eyelid, vision or ocular mobility. The biopsy of the tumor resection shows an extraocular sebaceous carcinoma.

Sebaceous carcinoma in a mature teratoma of the ovary

The finding of a sebaceous carcinoma in a mature teratoma is rare in human pathology, with fewer than 10 cases currently reported in the literature. In this article, we report a case of sebaceous carcinoma in a mature teratoma of the ovary in a 59-year-old patient and discuss its histological findings.

A unique case of isolated sebaceous adenoma of the bulbar conjunctiva / Um caso único de adenoma sebáceo isolado de conjuntiva bulbar

ABSTRACT Our patient was a 34 year-old male who presented with a painless conjunctival mass that had developed 3 months before his first visit. On performing slit-lamp biomicroscopy, a lobulated pink-yellowish solid mobile mass was observed on the nasal bulbar conjunctival surface of his left eye. The tumor was excised, and histopathologic examination of the tumor revealed a sebaceous adenoma. Systemic examination was normal. No recurrence was observed during the 24-month follow-up period. Sebaceous adenoma of the bulbar conjunctiva is an extremely rare benign tumor, which may be observed to be isolated in the absence of malignancy.

RESUMO Nosso paciente era um homem de 34 anos que apresentou uma massa conjuntival indolor desde há 3 meses antes da primeira consulta. Na biomicroscopia por lâmpada de fenda, observa-se uma massa rosa-amarelada, sólida, móvel e lobulada na superfície conjuntival bulbar nasal, em seu olho esquerdo. O tumor foi retirado e o exame histopatológico demonstrou um adenoma sebáceo. O exame sistêmico era normal. Nenhuma recidiva foi observada durante os 24 meses de acompanhamento. Adenoma sebáceo da conjuntiva bulbar é um tumor benigno extremamente raro e pode ser visto isolado, sem quaisquer doenças malignas associadas.

Nevus sebáceo cerebriforme: uma rara apresentação

A 13-year-old boy presented congenital, raised, yellowish colored plaques with fibroelastic consistency, which were velvety in appearance, alopecic, with clearly defined limits and sulci or well-marked meandering invaginations, a cerebriform appearance on the upper part of the right ear, accompanied by alopecia in the temporomandibular region-parietal. The lesion was asymptomatic. Histopathologic examination revealed acanthosis, hyperkeratosis, papillomatosis and follicular plugging in the epidermis. The upper dermis showed underdeveloped hair follicles with sebaceous glands, consistent with sebaceous nevus. There were no skeletal, cardiological, ophthalmological or neuropsychomotor changes; nor were there any records of relevant pathologies in the family history. The patient complained of his appearance, experiencing aesthetic and social issues. Following a diagnosis of cerebriform nevus sebaceous, complete excision was performed with excellent aesthetic results.

Cerebriform sebaceous nevus: a rare presentation

Abstract A 13-year-old boy presented congenital, raised, yellowish colored plaques with fibroelastic consistency, which were velvety in appearance, alopecic, with clearly defined limits and sulci or well-marked meandering invaginations, a cerebriform appearance on the upper part of the right ear, accompanied by alopecia in the temporomandibular region-parietal. The lesion was asymptomatic. Histopathologic examination revealed acanthosis, hyperkeratosis, papillomatosis and follicular plugging in the epidermis. The upper dermis showed underdeveloped hair follicles with sebaceous glands, consistent with sebaceous nevus. There were no skeletal, cardiological, ophthalmological or neuropsychomotor changes; nor were there any records of relevant pathologies in the family history. The patient complained of his appearance, experiencing aesthetic and social issues. Following a diagnosis of cerebriform nevus sebaceous, complete excision was performed with excellent aesthetic results.

Cuerno cutáneo y carcinoma sebáceo: diagnóstico diferencial a propósito de un caso / Cutaneous horn and sebaceous carcinoma: differential diagnosis of a case report

El cuerno cutáneo es un concepto semiológico. Se define como una lesión tumoral hiperqueratósica de aspecto cónico y tamaño variable, que puede tener como base una lesión de origen benigno, premaligno o maligno. El tratamiento consiste en la resección completa de la lesión, seguido de un estudio histopatológico para precisar el diagnóstico. El carcinoma sebáceo, neoplasia maligna derivada del epitelioanexial de las glándulas sebáceas, se ha descrito como una etiología poco frecuente de cuerno cutáneo. Su diagnóstico es difícil, ya que carece de elementos clínicos característicos y su histología puede ser similar al carcinoma espinocelular o basocelular, pero importante ya que constituye una neoplasia agresiva, con riesgo de recurrencia local y metástasis. A continuación, presentamos el caso de un hombre de 68 años con diagnóstico clínico de cuerno cutáneo palpebral y diagnóstico histopatológico de carcinoma sebáceo.

The cutaneous horn is a semiological concept. It is defined as an hyperkeratotic tumor of conical appearance and variable size, which may be based on benign, premalignant or malignant lesion. The treatment is the complete resection followed by an histopathology study to clarify the diagnosis. Sebaceous carcinoma, malignant neoplasm derived from adnexal epithelium of sebaceous glands, has been described as a rare etiology of cutaneous horn. Diagnosis is difficult because it doesn’t have characteristic clinical features and histology may be similar to squamous or basal cell carcinoma, but it is important because is an aggressive neoplasm with risk of local recurrence and metastasis. We present a case of a 68-year-old man, with a clinical diagnosis of eyelid cutaneous horn and histopathological diagnosis of sebaceous carcinoma.

Extra ocular sebaceous adenocarcinoma in HIV-positive patient - case report / Adenocarcinoma sebaceo extra-ocular em paciente HIV positivo - relato de caso

Sebaceous adenocarcinoma is a rare adnexal tumor that can affect the skin and is divided into ocular, a more common form and extra ocular, of a rarer occurrence. We report the case of a patient diagnosed with Acquired Immune Deficiency Syndrome (AIDS) who developed an extra ocular, bulky and fast-growing sebaceous adenocarcinoma on the face. The literature has suggested that transplanted patients and HIV-positive patients have an excess risk for developing adnexal tumors, including sebaceous adenocarcinoma.

Adenocarcinoma sebáceo é um tumor anexial raro que pode envolver a pele e é dividido em ocular, mais comum e extraocular, mais raro. Relatamos o caso de um paciente com diagnóstico de Síndrome da Imunodeficiência Adquirida que desenvolveu um adenocarcinoma sebáceo extra-ocular, na face, volumoso, de rápido crescimento. A literatura tem sugerido que pacientes transplantados e portadores do vírus da imunodeficiência humana têm um excesso de risco para o desenvolvimento de tumores anexiais, incluindo o Adenocarcinoma sebáceo.

Inguinal ulcerated sebaceous carcinoma: an unusual presentation / Carcinoma sebaceo inguinal ulcerado: apresentacao incomum

Sebaceous carcinoma is a rare and aggressive skin tumor. It can be located in any area of the body, the most commonly involved area being the periorbital region. It does not entail a typical clinical presentation, which explains the often late diagnosis. The aim of this report is to outline the rarity of the disease and its atypical clinical description, since to this day, inguinal ulcers with clinical manifestation have not been reported. We present and discuss a case of sebaceous carcinoma with an unusual clinical presentation, in an elderly male patient. The precise approach to genital ulcers, as shown in this case, is a diagnostic challenge that requires a great deal of effort on the part of the clinician.

O carcinoma sebáceo é um tumor cutâneo raro e agressivo. Pode localizar-se em qualquer área do corpo sendo a região periorbital a mais comumente envolvida. Ele não tem uma apresentação clínica típica, o que explica o diagnóstico frequentemente tardio. O objetivo deste relato é apresentar a raridade da doença e uma descrição clínica atípica, uma vez que, até a presente data, não foi relatada úlcera inguinal como manifestação clínica. Apresentamos e discutimos um caso de carcinoma sebáceo, com uma apresentação clínica incomum em um paciente idoso do sexo masculino. A abordagem de úlceras genitais, como mostrado no presente caso, é um desafio diagnóstico que requer uma grande quantidade de esforço por parte do clínico.

A case of giant sebaceoma

Sebaceoma is a benign tumor with sebaceous differentiation. It usually presents as a yellowish papule or nodule on the face and scalp. This is a report of a 27-year-old-woman who presented with a giant, 6cmx4.5 cm exophytic tumor on her head. Clinically, we considered several diseases; however, the histological and immunohistochemical features matched those of sebaceoma. The lesion was excised and the defect was repaired by a split-thickness graft

Primary Sebaceous Carcinoma of the Corneaoscleral Limbus With Pagetoid Recurrence

We report a sebaceous carcinoma confined to the corneoscleral limbus without involvement of the eyelid. A 60-year-old man, who showed multiple masses on the corneaoscleral limbus and limbal ulceration but with normal eyelids, underwent surgical en-bloc excision of the masses. Histopathologic examination revealed a sebaceous carcinoma. Three weeks after excision, multiple pagetoid recurrences were found along the bulbar conjunctiva 2 mm away from the limbus. After the application of topical mitomycin C, the pagetoid spread regressed completely. After a 2 year follow-up, no other local or systemic recurrences were observed. This report shows that the ulcerative mass which is confined to only the corneoscleral limbus may be a sebaceous carcinoma even without eyelid involvement. Topical mitomycin C may be effective for treating pagetoid spread of sebaceous carcinoma of limbal origin.

Extensive extraocular sebaceous cell carcinoma with intracranial extension

This is a case report of an uncommon extraocular sebaceous cell carcinoma with intracranial extension and review of pertinent literature. A 42 year old, female presented us with an extensive mass involving almost the whole of her face. The histopathological evaluation of the biopsy obtained from the mass revealed it to be a sebaceous cell carcinoma. The radiological evaluation of the tumour revealed an intracranial extension. The patient died within 6 weeks of her initial presentation to us. We concluded it as an extremely rare case of an extraocular sebaceous cell carcinoma with intracranial extension