Sebaceous Adenoma Follow-up

  • Author: Grace F Kao, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jan 12, 2012
 

Further Inpatient Care

Except for the patients with Muir-Torre syndrome, no inpatient care is recommended for patients with sebaceous adenoma.

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Further Outpatient Care

Completely remove sebaceous adenomas surgically to prevent local recurrences.

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Transfer

Consulting other specialists for patients with suspected Muir-Torre syndrome is recommended to rule out the presence of an occult internal malignancy.

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Prognosis

Sebaceous adenomas are benign tumor growths that derive from sebaceous glands. Solitary tumors are treated by complete surgical removal with a 100% cure rate. Incomplete removal has occasionally resulted in local recurrence.

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Patient Education

Advise older patients (>60 y) of the potential existence of an internal malignancy when multiple sebaceous neoplasms are present.

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Contributor Information and Disclosures
Author

Grace F Kao, MD  Clinical Professor of Dermatopathology, Department of Dermatology, University of Maryland School of Medicine and George Washington University Medical School; Director, Dermatopathology Section, Department of Pathology and Laboratory Medicine, Veterans Affairs Maryland Healthcare System, Baltimore, Maryland

Grace F Kao, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and International Society of Dermatopathology

Disclosure: Nothing to disclose.

Specialty Editor Board

Evan R Farmer, MD  Clinical Professor of Pathology and Dermatology, Department of Pathology, Virginia Commonwealth University School of Medicine

Evan R Farmer, MD is a member of the following medical societies: American Academy of Dermatology, American Dermatological Association, American Medical Association, American Society of Dermatopathology, and International Society of Dermatology

Disclosure: Nothing to disclose.

Richard P Vinson, MD  Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Warren R Heymann, MD  Head, Division of Dermatology, Professor, Department of Internal Medicine, University of Medicine and Dentistry of New Jersey-New Jersey Medical School

Warren R Heymann, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

The author wishes to thank G. William Moore, MD, PhD, and Lawrence A. Brown, MD, for assistance in reviewing and editing the manuscript and for technical support.

References

  1. Mehregan AH, Pinkus H. Life history of organoid nevi. Special reference to nevus sebaceus of Jadassohn. Arch Dermatol. Jun 1965;91:574-88. [Medline].

  2. Ito K, Sato S, Nishijima A, Hiraga K, Hidano A. Melanogenic melanocytes in human sebaceous glands. Experientia. Apr 15 1976;32(4):511-2. [Medline].

  3. Ormsby AH, Snow JL, Su WP, Goellner JR. Diagnostic immunohistochemistry of cutaneous metastatic breast carcinoma: a statistical analysis of the utility of gross cystic disease fluid protein-15 and estrogen receptor protein. J Am Acad Dermatol. May 1995;32(5 Pt 1):711-6. [Medline].

  4. Swanson PE. Monoclonal antibodies to human milk fat globule proteins. In: Wick MR, Siegal GP, eds. Monoclonal antibodies in diagnostic immunohistochemistry. New York, NY: Marcel Dekker; 1988:227-84.

  5. Bayer-Garner IB, Givens V, Smoller B. Immunohistochemical staining for androgen receptors: a sensitive marker of sebaceous differentiation. Am J Dermatopathol. Oct 1999;21(5):426-31. [Medline].

  6. Shikata N, Kurokawa I, Andachi H, Tsubura A. Expression of androgen receptors in skin appendage tumors: an immunohistochemical study. J Cutan Pathol. Apr 1995;22(2):149-53. [Medline].

  7. Muir EG, Bell AJ, Barlow KA. Multiple primary carcinomata of the colon, duodenum, and larynx associated with kerato-acanthomata of the face. Br J Surg. Mar 1967;54(3):191-5. [Medline].

  8. Torre D. Multiple sebaceous tumors. Arch Dermatol. Nov 1968;98(5):549-51. [Medline].

  9. Ollila S, Fitzpatrick R, Sarantaus L, et al. The importance of functional testing in the genetic assessment of Muir-Torre syndrome, a clinical subphenotype of HNPCC. Int J Oncol. Jan 2006;28(1):149-53. [Medline].

  10. Rütten A, Burgdorf W, Hugel H, et al. Cystic sebaceous tumors as marker lesions for the Muir-Torre syndrome: a histopathologic and molecular genetic study. Am J Dermatopathol. Oct 1999;21(5):405-13. [Medline].

  11. Suspiro A, Fidalgo P, Cravo M, et al. The Muir-Torre syndrome: a rare variant of hereditary nonpolyposis colorectal cancer associated with hMSH2 mutation. Am J Gastroenterol. Sep 1998;93(9):1572-4. [Medline].

  12. Heyl J, Mehregan D. Immunolabeling pattern of cytokeratin 19 expression may distinguish sebaceous tumors from basal cell carcinomas. J Cutan Pathol. Jan 2008;35(1):40-5. [Medline].

  13. Smith J, Crowe K, McGaughran J, Robertson T. Sebaceous adenoma arising within an ovarian mature cystic teratoma in Muir-Torre syndrome. Ann Diagn Pathol. Jun 16 2011;[Medline].

  14. Landis MN, Davis CL, Bellus GA, Wolverton SE. Immunosuppression and sebaceous tumors: a confirmed diagnosis of Muir-Torre syndrome unmasked by immunosuppressive therapy. J Am Acad Dermatol. Nov 2011;65(5):1054-1058.e1. [Medline].

  15. Misago N, Toda S, Narisawa Y. Two histopathologic patterns of well-differentiated extraocular sebaceous carcinoma. J Cutan Pathol. Oct 2011;38(10):767-74. [Medline].

  16. Troy JL, Ackerman AB. Sebaceoma. A distinctive benign neoplasm of adnexal epithelium differentiating toward sebaceous cells. Am J Dermatopathol. Feb 1984;6(1):7-13. [Medline].

  17. Sachez Yus E, Requena L, Simon P, del Río E. Sebomatricoma: a unifying term that encompasses all benign neoplasms with sebaceous differentiation. Am J Dermatopathol. Jun 1995;17(3):213-21. [Medline].

  18. Banse-Kupin L, Morales A, Barlow M. Torre's syndrome: report of two cases and review of the literature. J Am Acad Dermatol. May 1984;10(5 Pt 1):803-17. [Medline].

  19. Hashimoto K, Mehregan AH, Kumakiri M. Tumors of Skin Appendages. Boston, Mass: Butterworth-Heinemann; 1987.

  20. Latham JA, Redfern CP, Thody AJ, De Kretser TA. Immunohistochemical markers of human sebaceous gland differentiation. J Histochem Cytochem. May 1989;37(5):729-34. [Medline].

  21. Lynch HT, Fusaro RM, Roberts L, Voorhees GJ, Lynch JF. Muir-Torre syndrome in several members of a family with a variant of the Cancer Family Syndrome. Br J Dermatol. Sep 1985;113(3):295-301. [Medline].

  22. Misago N, Narisawa Y. Sebaceous neoplasms in Muir-Torre syndrome. Am J Dermatopathol. Apr 2000;22(2):155-61. [Medline].

  23. Ponti G, Ponz de Leon M. Muir-Torre syndrome. Lancet Oncol. Dec 2005;6(12):980-7. [Medline].

  24. Steffen C, Ackerman AB. Neoplasms With Sebaceous Differentiation. Philadelphia, Pa: Lea & Febiger; 1992.

  25. Tsalis K, Blouhos K, Vasiliadis K, Tsachalis T, Angelopoulos S, Betsis D. Sebaceous gland tumors and internal malignancy in the context of Muir-Torre syndrome. A case report and review of the literature. World J Surg Oncol. 2006;4:8. [Medline].

  26. Wick MR, Swanson PE. Cutaneous Adnexal Tumors: A Guide to Pathologic Diagnosis. Chicago, Ill: ASCP Press; 1991.

  27. Zaim MT. Sebocrine adenoma. An adnexal adenoma with sebaceous and apocrine poroma-like differentiation. Am J Dermatopathol. Aug 1988;10(4):311-8. [Medline].

 
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A biopsy-proven sebaceous adenoma on the forehead of a 64-year-old man. The tumor appeared as a dome-shaped, elevated nodule with a circumscribed margin. It measured 8 mm in diameter, with a smooth, shiny, yellow, and speckled appearance. The tumor had a history of slow growth, and the patient had noticed it for more than a year. Note the pearly appearance and the presence of a few capillaries traversing the tumor surface, a feature closely mimicking the clinical appearance of that of a basal cell carcinoma. The total surgical removal of this tumor was uneventful. The patient has not experienced a recurrence.
Low-power view of a photomicrograph of sebaceous adenoma. Note the dome-shaped elevation of the epidermal surface, the sharp circumscription from the adjacent dermal tissue, and the slight central cystic appearance with eosinophilic secretory material. Patients with sebaceous tumors showing more prominent cystic change have been found to have DNA abnormalities that are linked to a higher risk of the development of internal malignancies at a later date.
A medium-power view of the well-differentiated SA on the forehead of a 64-year-old man, showing proliferation of well-differentiated sebaceous lobules with central, larger, mature sebocytes and peripheral, smaller, less-differentiated, basaloid, germinative cells. Note that the sebaceous lobules are connected to the overlying epidermis and are slightly off-center in this field; a collection of eosinophilic, pink-colored, keratinous material is present in a dilated follicular ostium within the tumor (hematoxylin and eosin, original magnification X75). In contrast to a sebaceous hyperplasia, a sebaceous adenoma such as seen in this microscopic field contains sebaceous lobules with a 2-cell type and not a single-cell type of sebocytes as seen in the former. The neoplasm was completely removed, with no known recurrences to date.
Higher-power view of a photomicrograph of a sebaceous adenoma. Note the intermingled 2 cell types, ie, well-differentiated pale-staining sebocytes containing vacuolated (bubbly) cytoplasm and smaller, darkly stained, basaloid, less-differentiated matrix cells. An occasional mitotic figure (arrow) was present. The tumor was completely excised, and no recurrence was noted in this patient after 5 years of follow-up (hematoxylin and eosin, original magnification X200).
A close-up, higher-power view of the same sebaceous adenoma. The cytologic details are evident. Notice the predominant, larger sebocytes (arrow) containing pale-staining, bubbly cytoplasm (intracytoplasmic compartmentalization) and a few smaller, basaloid, germinative cells of pilosebaceous structures. The nuclei are vesicular without overt pleomorphism or mitotic activity (hematoxylin and eosin, original magnification X300).
Multiple sebaceous neoplasms on the skin of the chest and the trunk of a 62-year-old man. The tumors were biopsy-proven sebaceous tumors with varying degrees of sebaceous differentiation. The patient was found to have a well-differentiated adenocarcinoma of the colon by subsequent colonoscopy, CT scan, and MRI examination.
 
 
 
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