Department of Surgery, School of Medicine, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá D.C., Colombia.
Unit of Surgical Oncology, Hospital Universitario San Ignacio, Bogotá D.C., Colombia.
J Med Case Rep. 2024 Nov 26;18(1):570. doi: 10.1186/s13256-024-04779-7.
Extra ocular sebaceous carcinoma is a very rare, aggressive, malignant tumor arising in the adnexal epithelium of sebaceous gland that account for only about 25% of all sebaceous carcinomas (Wick et al. in Cancer 56(5):1163-72, 1985). The diagnosis of this tumor is difficult because its clinical appearance is atypical. The common treatment consists in wide local excision of the lesion with removal of local lymph node. We report the second case of sebaceous carcinoma involving the back. It was treated with surgical excision and sentinel lymph node biopsy.
A 69 year-old Caucasian woman presented with an erythematous, violaceus and exophytic lesion with central ulceration and leakage of purulent material in dorsal region at the level of T10-T11, measuring 7 × 6 cm in size. A biopsy of the lesion reported a moderately differentiated sebaceous carcinoma with lymph, vascular and perineural invasion. Extension studies revealed axillary lymphadenopathy and a renal lesion suggestive of angiomyolipoma based on tomographic findings. A biopsy of the axillary lymphadenopathy was performed, which was negative for malignancy. A wide excision of the lesion with a 2 cm margin and sentinel lymph node biopsy were performed. On histopathological examination was confirm the diagnosis of sebaceous carcinoma of the back. The patient had a good clinical course, and it was decided to follow up clinically every 6 months.
Sebaceous carcinoma can occur in locations other than the ocular region. It is frequently difficult to diagnose and has an unpredictable prognosis. The back is a particularly unusual site for this lesion. Surgery remains the mainstay of treatment, and a sentinel lymph node biopsy can be performed instead of removing all regional lymph nodes.
眼外皮脂腺癌是一种非常罕见的、侵袭性强的恶性肿瘤，发生于皮脂腺的附属上皮，仅占所有皮脂腺癌的 25%左右（Wick 等人，《癌症》56(5):1163-72, 1985）。由于其临床表现不典型，因此诊断此肿瘤较为困难。常见的治疗方法是广泛切除病变并切除局部淋巴结。我们报告第二例涉及背部的皮脂腺癌。它通过手术切除和前哨淋巴结活检进行治疗。
一位 69 岁的白人女性，背部 T10-T11 水平出现红斑、紫斑和外生性病变，中央溃疡，有脓性物质渗出，病变大小为 7×6cm。病变活检报告为中分化皮脂腺癌，伴淋巴、血管和神经周围侵犯。扩展研究显示腋窝淋巴结肿大和肾病变，基于断层扫描结果提示为血管平滑肌脂肪瘤。对腋窝淋巴结肿大进行了活检，未发现恶性肿瘤。对病变进行了广泛切除，切除边缘为 2cm，并进行了前哨淋巴结活检。组织病理学检查证实了背部皮脂腺癌的诊断。患者的临床过程良好，决定每 6 个月进行临床随访。
皮脂腺癌可发生于眼外部位。它经常难以诊断，且预后不可预测。背部是该病变特别罕见的部位。手术仍然是主要的治疗方法，并且可以进行前哨淋巴结活检，而不是切除所有区域淋巴结。
