DERMATOPATHOLOGY CASES: Self-Assessment Cases: Editor - Dr Sampurna Roy MD

Digital Images of interesting cases that will include the full spectrum of Dermatopathology, presented in the form of quiz.

The answer of the cases include related links and recent abstracts of articles.

Tuesday, December 29, 2009

Answer of Dermatopathology Case 27


Visit: Pathology of Sebaceoma
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Visit: Sebaceous Tumours and Tumour-like Lesions


Sebaceous lesions and their associated syndromes: part I. J Am Acad Dermatol. 2009 Oct;61(4):549-60; quiz 561-2.
Sebaceous neoplasms have long been a source of confusion to dermatologists and pathologists alike. Disagreements regarding nomenclature, classification, and management have been longstanding. Sebaceous lesions represent a broad spectrum of interesting entities that range from hamartomas, hyperplasias, and benign tumors to highly malignant neoplasms. This article discusses the clinical and pathologic features of sebaceous hyperplasia, nevus sebaceous of Jadassohn, sebaceous adenoma, seboacanthoma, sebaceous epithelioma, sebaceoma, mantleoma, basal cell carcinoma with sebaceous differentiation, sebomatricoma(sebomatrixoma), and sebaceous carcinoma. Controversies regarding these lesionswill be explored, and any relationship with Muir-Torre syndrome will be discussed.

Rippled-pattern sebaceoma: a clinicopathological study. Am J Dermatopathol. 2009 Jun;31(4):364-6.
We summarized the clinicopathological data of rippled-pattern sebaceoma diagnosed at Sapporo Institute for Dermatopathology and compared it with those of sebaceoma without rippled pattern. Eighty cases of sebaceoma, comprising 37 male and 43 female patients with a mean age at resection of 62.9 +/- 17.0 years, were reviewed. The lesions were located most frequently on the face (45.0%).Twenty-one (26.3%) of 80 cases of sebaceoma exhibited a rippled pattern. Rippled-pattern sebaceoma arose predominantly in males and most frequently on the scalp, whereas sebaceoma without rippled pattern occurred more frequently infemales and on the face. Histopathologically, sebaceoma without rippled pattern frequently associated with other neoplastic lesions including sebaceous nevus, seborrheic keratosis, and trichoblastoma on the same lesion; however, there were no associated lesions in rippled-pattern sebaceoma.

A case of sebaceoma with extensive apocrine differentiation.Am J Dermatopathol. 2008 Aug;30(4):408-11.
Apocrine differentiation is a rare event in sebaceoma, and only 3 cases have been reported. We report a case of sebaceoma with extensive apocrine differentiationon the scalp in a 73-year-old Japanese woman. The resected tumor was located entirely within the dermis and subcutis as a well-circumscribed, lobulated, solid, and partially cystic mass, measuring 35 mm at the largest diameter. Histopathologically, it was composed of uniform basaloid cells with clusters of sebocytes, squamous islands of ductal structures, and apocrine cells with apparent decapitation secretion. Nuclear atypia of all types of cells was inconspicuous, and mitotic figures were infrequent. We considered the lesion tobe a sebaceoma with apocrine differentiation.

Sebaceoma of the external ear canal: an unusual location. Case report and review of the literature. J Cutan Pathol. 2008 Oct;35(10):963-6.
Sebaceous neoplasms of the external ear canal are extremely rare. Only two cases of sebaceous neoplasms have been reported in the English literature, a sebaceous carcinoma and a sebaceous adenoma. We report a case of sebaceoma of the external ear canal. To the best of our knowledge, sebaceoma of the auditory canal has not been reported previously. We highlight the differential diagnosis, particularly sebaceous carcinoma and basal cell carcinoma with sebaceous differentiation. Awareness of the possible occurrence of sebaceoma in the auditory canal mayprevent the diagnostic pitfall of misidentifying this tumor.