Irina Bolm1, Gregor Babaryka2, Maximilian Moergel1, Bilal Al-Nawas1, Peer W Kämmerer3. 1. Department of Cranio-Maxillo-Facial Surgery and Plastic Surgery, University Medical Centre of the Johannes Gutenberg University Mainz, Augustusplatz 2, 55131 Mainz, Germany. 2. Institut für Allgemeine Pathologie und Pathologische Anatomie der Technischen Universität München, Klinikum rechts der Isar, Munich, Germany. 3. Department of Cranio-Maxillo-Facial Surgery and Plastic Surgery, University Medical Centre of the Johannes Gutenberg University Mainz, Augustusplatz 2, 55131 Mainz, Germany ; Harvard Medical School, Boston, MA USA.
Abstract
PURPOSE: Sebaceous carcinoma (SC) is a rare adnexal tumor. Extra-ocular, facial SC is very uncommon and local metastases are an extreme rare finding. A respective case is presented and discussed together with the current literature. CASE AND REVIEW: A tumor of the left ear of an 87-old male was primary excised together with multiple suspicious lesions of the head and neck. Most specimens were histopathologically rated as squamous cell carcinomas (SCC). Despite the in-sano resection, additional new suspicious retro-auricular and temporal lesions were detected. Successive resections were diagnosed as basal cell carcinomas (BCC) and, because of a non-in-sano resection in a third approach, as SC. After reappraisal and immunhistochemical staining [epithelial membrane antigen (EMA), CK 5-6 and CD 15], most of the former specimens turned out to be SC as well. A literature search showed 3 reported cases of extra-ocular head and neck SC with cutaneous local metastases. In another review, in a total of 168 cases, SC was diagnosed after wrong initial histological diagnosis (SCC n = 56, BCC n = 44; other entity or precursors of carcinomas n = 68). CONCLUSION: Due to inconsistent histologic patterns, histopathological misdiagnosis of the uncommon facial SC and its metastases may complicate further therapy, prolong treatment and may lead to a worse prognosis of this neoplasm. A close interdisciplinary collaboration of clinician, surgeon and pathologist is of most relevance for the right diagnosis.
PURPOSE: Sebaceous carcinoma (SC) is a rare adnexal tumor. Extra-ocular, facial SC is very uncommon and local metastases are an extreme rare finding. A respective case is presented and discussed together with the current literature. CASE AND REVIEW: A tumor of the left ear of an 87-old male was primary excised together with multiple suspicious lesions of the head and neck. Most specimens were histopathologically rated as squamous cell carcinomas (SCC). Despite the in-sano resection, additional new suspicious retro-auricular and temporal lesions were detected. Successive resections were diagnosed as basal cell carcinomas (BCC) and, because of a non-in-sano resection in a third approach, as SC. After reappraisal and immunhistochemical staining [epithelial membrane antigen (EMA), CK 5-6 and CD 15], most of the former specimens turned out to be SC as well. A literature search showed 3 reported cases of extra-ocular head and neck SC with cutaneous local metastases. In another review, in a total of 168 cases, SC was diagnosed after wrong initial histological diagnosis (SCC n = 56, BCC n = 44; other entity or precursors of carcinomas n = 68). CONCLUSION: Due to inconsistent histologic patterns, histopathological misdiagnosis of the uncommon facial SC and its metastases may complicate further therapy, prolong treatment and may lead to a worse prognosis of this neoplasm. A close interdisciplinary collaboration of clinician, surgeon and pathologist is of most relevance for the right diagnosis.
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