Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current Issue
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
Images in Dermatology
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Media and news
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Images
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Reviewers 2022
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Snippets
Special Article
Specialty Interface
Studies
Study Letter
Study Letters
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Review and Meta-Analysis
Systematic Reviews and Meta-analyses
Systematic Reviews and Meta-analysis
Tables
Technology
Therapeutic Guideline-IADVL
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
Therapy Letters
View Point
Viewpoint
What’s new in Dermatology
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current Issue
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
Images in Dermatology
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Media and news
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Images
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Reviewers 2022
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Snippets
Special Article
Specialty Interface
Studies
Study Letter
Study Letters
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Review and Meta-Analysis
Systematic Reviews and Meta-analyses
Systematic Reviews and Meta-analysis
Tables
Technology
Therapeutic Guideline-IADVL
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
Therapy Letters
View Point
Viewpoint
What’s new in Dermatology
View/Download PDF

Translate this page into:

Net letter
2011:77:3;403-403
doi: 10.4103/0378-6323.79745
PMID: 21508595

A case of giant sebaceous carcinoma localized in the breast area of a male patient

Antonio Ascari-Raccagni1 , Adina Dondas2 , Franco Padovani3 , Carlo Milandri4 , Maria Giovanna Righini5 , Giusto Trevisan6
1 Dermatological Surgery Unit, Department of Dermatology, Morgagni-Pierantoni Hospital, Forlì;University of Siena, Siena, Italy
2 Dermatological Surgery Unit, Department of Dermatology, Morgagni-Pierantoni Hospital, Forlì;Institute of Dermatology, University of Trieste, Trieste, Italy
3 Pathology Unit, Morgagni-Pierantoni Hospital, Forlì, Italy
4 Department of Medical Oncology, Isituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Meldola, Italy
5 Dermatological Surgery Unit, Department of Dermatology, Morgagni-Pierantoni Hospital, Forlì, Italy
6 Institute of Dermatology, University of Trieste, Trieste, Italy

Correspondence Address:
Antonio Ascari-Raccagni
Dermatological Surgery Unit, Department of Dermatology, Morgagni-Pierantoni Hospital, via Forlanini 34, 47121 Forli
Italy
How to cite this article:
Ascari-Raccagni A, Dondas A, Padovani F, Milandri C, Righini MG, Trevisan G. A case of giant sebaceous carcinoma localized in the breast area of a male patient. Indian J Dermatol Venereol Leprol 2011;77:403
Copyright: (C)2011 Indian Journal of Dermatology, Venereology, and Leprology

Sir,

Cutaneous sebaceous carcinoma (SC) is a rare, aggressive tumor that originates in the holocrine adnexal epithelium of sebaceous glands. Around 400 cases have been reported to date in the literature, of which 120 were extra-orbital in origin and the remaining periorbital. [1] Extra-ocular SC occurs predominantly in the head and neck area, where the concentration of sebaceous glands is highest. Other uncommon locations include the external genitalia, trunk and limbs. We report a case of a giant sebaceous carcinoma localized in the breast area of a male patient.

A 61-year-old man was seen in our department for a large, painless, ulcerated lesion localized in the left breast area, measuring 12 x 9 cm [Figure - 1]. The lesion had first appeared four years earlier and had slowly grown, gradually including and then totally destroying the homo-lateral nipple. The ulcerated neoformation was well-circumscribed and slightly elevated, with bright red edges. The bottom central part of the lesion was depressed, yellowish and foul-smelling. The patient had never consulted his general physician about it and had never used any kind of topical or systemic therapy in an attempt to resolve the problem.

Figure 1: Ulcerated lesion with bright red edges localized in the area of the left breast (12 × 9 cm)

Initial diagnostic hypotheses were made of an invasive cutaneous basal cell carcinoma gradually extending into the breast or a male breast carcinoma involving superficial tissue layers. A large diamond-shaped biopsy was performed, including both edges and central part of the lesion. Histological evaluation was performed with hematoxylin and eosin staining, revealing neoplastic dermal lobular proliferation of epithelial cells with sebocytic differentiation. The tumor cells showed a large, eosinophilic, clear, vacuolated cytoplasm and voluminous nucleus; numerous atypical mitoses were also present [Figure - 2].Neoplastic cell immunoreactivity was observed for epithelial membrane antigen (EMA), with a distinctive pattern of cytoplasmic "bubbliness" [Figure - 3].

Histological examination confirmed a diagnosis of ulcerated, infiltrating sebaceous carcinoma (SC), a rare cutaneous malignancy arising from the holocrine adnexal epithelium of sebaceous glands.

Figure 2: Tumor cells with sebaceous differentiation showing brisk mitotic activity (arrow) (H and E, ×40)
Figure 3: Tumor cells showing a distinctive pattern of cytoplasmic "bubbliness" (arrow) (EMA, ×40)

The patient reported intense pain in the spinal area, urination and defecation discomfort and modest spastic paraparesis. Contrast-enhanced computed tomography (CT) of the brain, chest and abdomen and magnetic resonance imaging (MRI) of the spine were carried out, highlighting secondary osteolytic processes involving the cervical, chest and lumbar vertebra and the sacrum and rib cage area, with collapse of D10 and D11, in addition to several large left axillary adenopathies. The tumor had spread to the vertebral column at the chest and lumbar level. Gastroenterologic and urologic investigations were performed and were negative, thus excluding the possibility of an association with the Muir-Torre syndrome.

Due to the size of the primary lesion and the extension of the secondary lesions, surgery was not considered as an option. As there were signs of the onset of spinal cord compression, the patient underwent high-dose dexamethasone treatment and radiotherapy on the dorsal spine. Osteotropic therapy with zoledronic acid, systemic chemotherapy with carboplatin and 5-fluorouracil, and opioid analgesic therapy were also initiated. [2] A stiff corset/bust, foam rubber collar and wheelchair were prescribed.

The cutaneous lesion is currently in slow regression and the patient is undergoing regular follow-up.

Sebaceous carcinoma is a rare tumor without a distinctive appearance, it is often mistaken for sebaceous adenoma, basal cell carcinoma with sebaceous differentiation, squamous cell carcinoma, clear cell hidradenocarcinoma, metastatic renal cell carcinoma and metastatic prostate cancer.

SC is classified into two main groups: periocular SC, which arises from the ocular sebaceous glands and an extra-ocular form, threefold less common than the former type.

SC can occur spontaneously or in combination with the Muir-Torre syndrome, a rare autosomal dominant genodermatosis characterized by sebaceous gland tumors and/or keratoacanthoma associated with visceral malignancies, including gastrointestinal and genitourinary cancers. [3],[4]

References
1.
Dowd MB, Kumar RJ, Sharma R, Murali R. Diagnosis and management of sebaceous carcinoma: an Australian experience. ANZ J Surg 2008;78:158-63.
[Google Scholar]
2.
Wu CY. Muir-Torre syndrome: Extraocular sebaceous carcinoma with adenocarcinoma of colon in a 76-year-old man. Clin Exp Dermatol 2009;34:e399-400.
[Google Scholar]
3.
Abbas O, Mahalingam M. Cutaneous sebaceous neoplasms as markers of Muir-Torre syndrome: A diagnostic algorithm. J Cutan Pathol 2009;36:613-9.
[Google Scholar]
4.
Murthy R, Honavar SG, Burman S, Vemuganti GK, Naik MN, Reddy VA. Neoadjuvant chemotherapy in the management of sebaceous gland carcinoma of the eyelid with regional lymph node metastasis. Ophthal Plast Reconstr Surg 2005;21:307-9.
[Google Scholar]

Fulltext Views
1,450

PDF downloads
2,284
Show Sections