Sebaceous Adenocarcinoma ICDO84103

This lesion is important because it can be a pitfall for both the clinician and the pathologist. The tumour presents as a solitary nodule, that can clinically be mis-diagnosed as a basal cell carcinoma or even as a cha-lazion or blepharoconjunctivitis [1, 36, 81]. Histologically, the tumour is composed of epithelial nests with varying sebaceous differentiation. The well-differentiated sebaceous carcinomas are not very hard to recognise, but the poorly differentiated ones can be easily missed. The intraepithelial pagetoid spread of tumour cells (which is frequently present) may be misinterpreted as dysplasia. Immunohistochemical stainings like EMA and CAM 5.2 can help in differentiating this aggressive tumour from a squamous cell carcinoma (Figs. 10.09-10.11). Treatment of choice is wide excision, which can cure patients at an early stage of the lesion. However, the mortality rate from metastases is 25%, and even higher in a poorly differentiated tumour with angioinvasive growth.

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