Carcinoid-like pattern in sebaceous neoplasms: another distinctive, previously unrecognized pattern in extraocular sebaceous carcinoma and sebaceoma.

This report emphasizes a carcinoid-like pattern, a previously unrecognized feature in cutaneous sebaceous neoplasms. We report 7 patients with sebaceous tumors in which neoplastic cells were arranged in a trabecular and ribbon-like pattern or formed rosettes/pseudorosettes. The cases included 6 men and 1 woman, with their ages at the diagnosis ranging from 43 to 87 years (median age, 59). All patients presented with a solitary lesion. Locations were the scalp (n = 6) and forearm (n = 1). The carcinoid-like arrangement of neoplastic cells was the sole pattern in 4 cases, and in 3 cases the so-called labyrinthine/sinusoidal and/or rippled patterns were seen in addition. Sebaceous differentiation in the form of mature sebocytes varied from almost none to approximately 10%. Although the neoplasm appeared benign architecturally, the presence of cytologic atypia qualified 2 tumors as low-grade carcinomas. Four lesions represented sebaceomas, and in 1 case microscopic delineation between a carcinoma and sebaceoma was difficult. No neuroendocrine differentiation was demonstrated immunohistochemically, histochemically, and ultrastructurally. Electron microscopic examination performed in 1 case of carcinoma revealed lipid vacuoles in a minority of cells. There were no membrane-bound neuroendocrine granules. Rare cells contained peculiar large helioid inclusions. We conclude that the carcinoid-like pattern is another distinctive pattern indicative of sebaceous neoplasms. This pattern seems to be closely related to the rippled and labyrinthine/sinusoidal patterns, as exemplified by our cases, in which these arrangements sometimes occurred simultaneously.

Esteatocistoma solitario vulvar: una localización inédita / Solitary vulvar steatocystoma: an unusual localization

No disponible

Sebaceous carcinoma of the submandibular gland with high-grade malignancy: report of a case.

A case of sebaceous carcinoma arising in the left submandibular gland of a 66-year-old man is reported. The clinical and pathological examinations revealed a carcinoma, which was to salivary gland in origin, with regional lymph nodal metastases. Pathological findings showed features of high-grade sebaceous carcinoma with spindle myoepitheliomatous differentiation. Neither squamous cell nor duct epithelial-like cell differentiation was noted. Immunohistochemically, tumor cells were positive for cytokeratin, S-100 protein and vimentin. Lipid was demonstrated in the cytoplasm of the tumor cells. Ultrastructurally, tumor cells contained numerous intracytoplasmic lipid droplets. Myoepitheliomatous differentiation is rare in sebaceous carcinoma of the salivary gland. Presented is the second reported case of sebaceous carcinoma arising in the submandibular gland.

Benign sebaceous neoplasm with prominent epidermal component.

A 65-year-old woman presented with a solitary nodule within an erythematous plaque in her right groin. Histopathologic examination showed central lobular proliferation of basaloid cells admixed with mature sebaceous cells and a lateral extensive intraepidermal component composed mostly of lobules of mature sebocytes consistent with intraepidermal epithelioma with sebaceous differentiation and focal invasion. Although various cutaneous neoplasms may show an intraepidermal growth pattern, extensive sebaceous differentiation in such a neoplasm, as seen in this case, has not been described. Electron-microscopic study revealed that the basaloid cells have features of pluripotential cells. This observation supports the previously reported concept that intraepidermal epithelioma may be composed of a group of heterogeneous tumors with various degrees and lines of differentiation. Additionally, sebaceous epithelioma/adenoma should be considered in the differential diagnosis of the cutaneous neoplasms with an intraepidermal growth pattern.

Assessment of cellular proliferation of sebaceous neoplasms by AgNOR counts and immunohistochemical demonstrations of PCNA and Ki-67.

We assessed cellular proliferation of sebaceous neoplasms by AgNOR counts and the immunohistochemical demonstration of proliferating cell nuclear antigen (PCNA) and Ki-67, using formalin-fixed and paraffin-embedded tissue specimens. We used three categories of sebaceous neoplasms: four cases of sebaceoma, three cases of basal cell carcinoma with sebaceous differentiation (BCSD), and seven cases of sebaceous carcinoma (SC). Significant differences were noted between SC and non-SC tumors (sebaceoma and BCSD) in AgNOR counts and semi-quantitative grading of PCNA and Ki-67 labelling indices (P < 0.01). When a cut-off value of 6 was chosen, the AgNOR value discriminated SC from non-SC tumors with high specificity and sensitivity. When a cut-off value of 25% was chosen, PCNA and Ki-67 labelling indices also discriminated between these tumors. Significant differences were not observed between sebaceoma and BCSD with PCNA and Ki-67 labelling indices. AgNOR counts of BCSD were a little higher than those of sebaceoma, but the number of cases was too small to perform statistical assessment. We consider AgNOR counts and semi-quantitative grading of PCNA and Ki-67 labelling indices to be useful in differentiating SC from BCSD and sebaceoma.

[Histological and immunohistochemical aspects of mucosal-epidermal junction following surgical reconstruction of upper aero-digestive tract]. / Caratteristiche istologiche ed immunoistochimiche della cicatrizzazione mucoso-cutanea nella riparazione chirurgica delle vads.

As a preliminary of the study of the possibility of upper aerodigestive tract reconstruction using "myomucosal" flaps derived by the classical pectoralis major myocutaneous flap, the evaluation of histologic and immunohistochemical modifications of epidermidis implanted in oral cavity and oropharynx has been conducted in 10 patients. The patients were operated for cancer of oral cavity and oropharynx and then reconstructed using the pectoralis major flap and biopsies from the mucosal-cutaneous junction were taken at different times from operation. Histologically, epidermidis preserved its morphology (a keratinized layer thinner but still present at 24 months by the operation, all the cutaneous annexes). A progressive modification of basal characteristics at the cutaneous side and rapid repair of the basal membrane were observed both histologically and immunohistochemically. In addition, a rich inflammatory infiltrate was present in the derma of the cutaneous area. Histochemistry demonstrated that mucosa and skin keep their own cytokeratin production although they repair in the absence of a fibrotic scar.

Anaplastic carcinoma of the lacrimal gland presenting with recurrent subconjunctival hemorrhages and displaying incipient sebaceous differentiation.

Primary adenocarcinomas of the lacrimal gland rarely display sebaceous differentiation. An anaplastic lacrimal gland neoplasm manifesting this feature was excised from a 64-year-old man who initially appeared with recurrent painless subconjunctival hemorrhages. Globe displacement and tumor-induced hyperopia were later findings. Electron microscopic studies performed on the widely excised tumor documented prominent lipid vacuoles, desmosomes, scattered cytoplasmic filaments, and linear segments of basement membrane material. The patient refused radical surgery and instead opted for 6,000 rads of adjuvant radiotherapy. Eleven months postoperatively liver and bone metastases developed, but he was free of local orbital recurrence. Twenty-two months postoperatively he died from complications of his metastatic disease. This most unusual lacrimal neoplasm is discussed in terms of its initial signs and symptoms and its histopathology. When the current case is analyzed in combination with three earlier reports, there is evidence that primary lacrimal gland sebaceous carcinoma is probably among the most malignant orbital tumors due to its uniform early fatality.

Distribution of glial fibrillary acidic protein (GFAP) in the intermediate filaments of the cultured cells from a patient with tuberous sclerosis.

We established a cell line (TS) from adenoma sebaceum of a patient with tuberous sclerosis. Through our previous studies, the abnormal cell division and dysfunction of TS cells were indicated. Glial fibrillary acidic protein (GFAP) and 55 kd protein had been to be major cytoskeletal proteins in these cells. This time we have examined the structure and distribution of cytoskeletons in TS cells with immunoelectron microscopy. TS cells were found to coexpress GFAP and vimentin-like substance; both structures seem to be closely related. The coexistence of a few kinds of proteins integrated in the cytoskeletons might lead to the abnormal behavior of the nucleus during the process of cell division.

Intraepidermal sebaceous carcinoma: case report.

We report a rare case of intraepidermal sebaceous carcinoma which occurred on the left upper arm of an old woman. Light-microscopic findings revealed that almost all the histopathological lesions were in the epidermis and showed pagetoid spread. The tumor was well differentiated and consisted of germinative, transitional and sebaceous cells. Mitosis and mild and moderate pleomorphism were observed. Ultrastructural findings revealed lipid droplets in the tumor cells although Sudan III staining failed to show any positive materials.

Sebaceous carcinoma of the parotid gland. An immunohistochemical and ultrastructural study.

Sebaceous carcinoma of salivary gland origin is extremely rare and, because of its rarity, the clinicopathological characteristics and the histogenesis are not fully understood. We present a case of sebaceous carcinoma of the parotid gland which brings the total number of reported cases to 22. The tumor showed epithelial cell nests which were mainly composed of sebaceous cells with marked cellular atypia. In most of the nests, glandular spaces lined by ductal epithelium were present. Scattered mucous cells and flattened eosinophilic cells at the periphery of the nests were also seen. Ultrastructural and immunohistochemical observations of the tumour revealed coexistence of sebaceous and glandular differentiations in some tumour cells. Tumour cells with lipid granules often participated in the formation of glandular structures or exhibited intracytoplasmic lumina, and immunohistochemical localization of lactoferrin and secretory component, the functional markers of ductal epithelium of salivary gland, was demonstrated not only in duct-forming tumour cells but also in many sebaceous tumour cells. It seems likely that sebaceous carcinoma originates from pluripotential duct cells which can differentiate into sebaceous, ductal and mucous cells.

Sebaceous adenocarcinoma of meibomian gland origin with targetoid intra-nuclear inclusions.

Neoplastic proliferation of the meibomian glands is most often characterized by a tarsal tumor of the eyelid conjunctiva, having the clinical appearance of a chalazion. As such, the tumor is frequently not recognized as a neoplasm and is treated conservatively as an inflammatory lesion. A protracted clinical course combined with repeated surgical excisions typify this slow-growing tumor of sebaceous gland cells. In addition to the usual features of polygonal cell shape, abundant cytoplasm, and numerous fat vacuoles, we describe the presence of a peculiar nuclear inclusion seen only in the parenchymal cells of this tumor, and having the appearance of concentric layers of electron-dense material surrounding an opaque electron lucent core.

Sebaceous cell adenoma. Rare intra-oral occurrence of a tumour which is a frequent marker of Torre's syndrome.

A case of sebaceous cell adenoma of the buccal mucosa in a 65-yr-old woman is described. The patient exhibited no manifestations of Torre's syndrome (cutaneous sebaceous neoplasms and visceral carcinomas). Only four sebaceous adenomas of the oral mucosa have been previously reported. The literature on neoplasms of sebaceous glands and Torre's syndrome is reviewed. The tumour had not recurred 18 months after surgical excision.

[A case of Torre's syndrome: association of a meibomian adenocarcinoma with a cecal tumor]. / A propos d'un cas de syndrome de Torre: association d'un adénocarcinome meibomien et d'une tumeur caecale.

The authors report a case of sebaceous adenocarcinoma of the eyelid developed in meibomian glands. This tumor grew slowly for several years and was diagnosed three years after an intestinal adenocarcinoma was discovered in the same patient. This case is part of a Torre's syndrome (association of a sebaceous neoplasm and a visceral malignancy). Such an association represents an original example of multiple tumors and shows that the discovery of a sebaceous tumor, benign or malignant, indicates a careful search of an internal malignancy.

Sebaceous carcinoma of the eyelid. Errors in clinical and pathologic diagnosis.

Sebaceous carcinoma of the eyelid is commonly misdiagnosed because it simulates other entities both clinically and pathologically. In a review of all pathologic material removed from the eyelids of patients at the Mayo Clinic between 1905 and 1981, 43 sebaceous carcinomas were discovered. The tumors manifested most frequently on the upper eyelid; the onset of symptoms occurred in 31 women and 12 men at a mean age of 61.5 years (range, 28-82 years). Of the 43 patients, 11 had an associated second malignant tumor or exposure to irradiation. The microscopic diagnosis was based on finding a proliferation of basophilic neoplastic cells with foamy cytoplasm and a positive fat stain. Intraepithelial neoplasia in the form of pagetoid change or carcinoma in situ was found in more than 80% of cases. Histologically, the tumor tended to be moderately differentiated. A high degree of infiltration was frequently observed cases with metastases. When intraepithelial neoplasia is observed microscopically, we recommend a fat stain on a frozen section and a full-thickness eyelid biopsy to exclude sebaceous carcinoma.

Tissue connections in a transplantable virus-producing sebaceous adenoma of the mouse. II. A freeze-fracture study in conjunction with filipin.

The distribution, size, and configuration of intercellular junctions in the sebaceous tumor of mice were examined using the freeze-fracture technique. Three types of junctions were observed: desmosomes, gap, and tight junctions. Tight junctions in general consisted of short linear unbranched fibrils, and macular or complex tight junctional patterns were present only occasionally. Gap junctions ranged from small sports of 0.9 x 10(-3) micrometer2 to areas of approximately 0.46 micrometers2. Desmosomes were the most frequent junctional specializations, and it is concluded that they are at least partially responsible for this tumor not being metastatic. Filipin in conjunction with freeze-fracture showed filipin-sterol complexes on the plasma membrane, the nuclear envelope, and the membranes of the endoplasmic reticulum and mitochondria. The intercellular junctions were devoid of these complexes indicating that these regions are low in cholesterol.