Sebaceous carcinoma is a rare and aggressive type of skin cancer that develops in a sebaceous gland, which produces sebum, a mixture of complex oils that help to lubricate the skin. Sebaceous carcinoma is also known as sebaceous gland carcinoma, sebaceous gland adenocarcinoma or meibomian gland carcinoma.
Most areas of the skin contain these sebaceous glands — they are largest and most concentrated on the face, in and around the eyes and on the scalp. These are the same glands that are associated with acne when they become clogged.
Sebaceous carcinoma appears in and around the eyes most often because they have the greatest number of sebaceous glands. A meibomian gland is a unique type of sebaceous gland found only on the eyelid. Because it is so rare, the causes of sebaceous carcinoma are poorly understood. As with other skin cancers, sun exposure may play a role, but that remains unclear.
Sebaceous carcinoma tumors grow slowly. If the cancer spreads, it can affect your eyesight. Although it can spread to other parts of the body, it is often treated successfully, especially if it is found early.
Symptoms of sebaceous carcinoma
The most common location for sebaceous carcinoma is on an eyelid and it may be mistaken for a stye or conjunctivitis (pink eye) but the growth can appear anywhere.
Be sure to alert your doctor to any new lump on the skin, especially one anywhere near your eye. A sebaceous carcinoma typically has the following characteristics:
- A pimple-like bump that feels firm, deep and thick
- Painless
- Yellow or reddish in color
- May bleed or ooze fluid
- May heal and then reappear
When sebaceous carcinoma develops elsewhere on the body, it is usually on the head or neck, and sometimes on the genitals, ear canal, breasts, chest, back, abdomen or buttocks. It looks like a slowly growing pink or yellowish lump and may bleed.
What causes sebaceous carcinoma?
People diagnosed with this rare skin cancer are most often between 60 and 80 years old, but it can develop at any age. Other risk factors for sebaceous carcinoma include:
- Weakened immune system
- Radiation treatments to the head or neck earlier in life
- Asian heritage
- Muir-Torre syndrome, a rare medical condition
When to see a doctor
Make an appointment to see a dermatologist immediately if you notice any of the following for more than 2 weeks:
- New growth on your skin, eyelid or inside your ear.
- Any growth or spot that starts to bleed, grow, or change in any way.
The dermatologist will conduct a thorough skin exam. The doctor may also remove part or all of the tumor to perform a skin biopsy for analysis by a dermatopathologist — a pathologist who specializes in diagnosing skin diseases and cancers. You may undergo one or more of the following tests to determine if it is cancerous and if it has spread beyond the primary site:
- Fine needle aspiration biopsy
- Lymph node biopsy
- Blood tests
- Potential imaging to look for distant spread x-ray
How is sebaceous carcinoma treated?
The primary treatment for sebaceous carcinoma is surgery, which may include one of the following procedures:
- Wide excision. With excision surgery, your surgeon removes the entire tumor and some surrounding healthy tissue to ensure that all the cancer is removed.
- Mohs micrographic surgery. This specialized type of skin cancer surgery requires the expertise of a dermatologist trained in Mohs surgery. During Mohs surgery, the surgeon removes affected tissue one layer at a time, examining each under a microscope. The process continues until no cancer cells are found.
After surgery, some patients may need plastic and reconstructive surgery (especially if the cancer was on the eyelid) to restore function and appearance. Roswell Park’s plastic and reconstructive surgeons work closely with our dermatologists and Mohs surgeons in order to perform the repair procedure immediately after the cancer surgery.
What's next after treatment?
Survival rate is high among patients whose sebaceous carcinoma is detected and treated at an early stage. However, sebaceous carcinoma is considered somewhat aggressive, and it can recur after treatment. For these reasons, it is important that patients follow up with their doctors as scheduled.