Table of contents
- What is Sebaceous Cell Carcinoma?
- What causes sebaceous cell carcinoma?
- What are the risk factors for sebaceous cell carcinoma?
- What are the signs and symptoms?
- How is sebaceous cell carcinoma diagnosed?
- What is the treatment for sebaceous cell carcinoma?
- What is the outlook for patients with sebaceous cell carcinoma?
What is Sebaceous Cell Carcinoma?
Sebaceous cell carcinoma is a rare type of skin cancer that develops in the oil-producing glands (sebaceous) of the skin. Sebaceous carcinoma mostly affects the eyelid but can develop on any part of the body because the sebaceous glands are under most of the skin, especially in hairy areas. It is also an aggressive type of cancer due to the speed of its spread. Sebaceous cell carcinoma is a rare type of cancer that only occurs in about 1% of skin cancer cases. Sebaceous carcinoma also mainly affects females, and older females to be exact (often in the 60-80 years range), but it can occur in other age ranges from younger to older adults and even in children.
What causes sebaceous cell carcinoma?
The exact cause of sebaceous cell carcinoma is unknown, but experts believe that, like most other types of skin cancer, ultraviolet rays from the sun may contribute to the development of this cancer. It may also be precipitated in some younger people who have been exposed to radiation therapy on their head or neck regions.
What are the risk factors for sebaceous cell carcinoma?
Individuals with a syndrome known as Muir-Torre syndrome have been found to be more likely to develop sebaceous cell carcinoma, as the syndrome is a form of Lynch syndrome which causes tumors to form in the sebaceous glands. Some of the other risk factors include:
- Overexposure to harsh sunlight (UV rays)
- Immune system depression by disease or medication
What are the signs and symptoms?
Many sebaceous cell carcinomas develop on the eyelid. The symptoms which can be observed are:
- Yellowish or reddish crust on the eyelid
- A slowly growing lump that feels firm and is often painless
- Thickening of the eyelid at its lash junction
- Growth on the eyelid that resembles a pimple
- A recurring sore on the eyelid that doesn’t heal
- Growth on the eyelid that bleeds
On progression, the cancer often mimics the symptoms of pink eye. There may be growth on the upper and lower eyelid, and the growths may open and ooze fluids. The eyelashes also eventually fall out, and the eyesight may be affected too. When a sebaceous cell carcinoma develops elsewhere in the body, it usually appears on either the head or the neck. Still, it can occasionally appear on the trunk, breast, genitals, etc. When it appears in these areas, it resembles a slowly growing pink or yellowish lump, and this lump may also bleed.
An individual should contact their health provider if they notice any of the following:
- Unusual changes to any mole or birthmarks on their skin
- Slow-growing bumps on the skin that bleeds easily and that may be yellowish or pinkish
- New skin growths, even the ones on the inside of the ear
Sebaceous cell carcinoma may also affect and inhibit the lymph nodes.
How is sebaceous cell carcinoma diagnosed?
A dermatologist usually conducts some tests in order to confirm the diagnosis. Some of the tests include:
- Skin exam – this is where the skin is carefully examined in order to understand the condition better.
- Eye examination – For sebaceous cell carcinoma that appears on the eyelid, it may be necessary to consult with an ophthalmologist, who will carefully examine the eye and the eyelid. They also look for signs that show that the cancer has spread to the tissue that covers the inside of the eyelid and the white of the eye.
- Skin biopsy – this is when a small amount of tissue is removed for testing. The specialized tests confirm if the cancer cells are present.
The diagnosis is then usually based on the findings from all of these examinations.
What is the treatment for sebaceous cell carcinoma?
The majority of skin cancers can be treated through relatively minimal surgery. There are two types of surgery that can be used to treat sebaceous cell carcinoma, they include:
- Excision – This is a procedure performed to eliminate the tumor along with the surrounding tissue, which appears healthy. It helps to remove any cancer that migrated to a surrounding area even though the area still looks healthy because it contains just a few cancer cells.
- Mohs surgery – this is recommended because most sebaceous cell carcinoma develops on the eyelid or other areas with very little extra skin. This technique is used to treat skin cancers, and it aims to remove less skin tissue while also removing the entire tumor. During the surgery, the surgeon cuts out the tumor plus a very small amount of healthy-looking tissue, which is then examined under the microscope to detect any sign of cancer cells. If there are any cancer cells, the surgeon then removes some more surrounding tissue and then examines it under the microscope also. This continues until the surgeon no longer detects any cancer cells at the edge of the removed tissue. After the surgery, some patients require reconstructive surgery, which is often performed immediately after the cancer surgery.
Surgery to remove the lymph nodes is done when the cancer spreads to the patient’s lymph nodes.
Other treatments which may be sought in combination with the surgery or after the surgery include:
Though it is usually done after surgery, it may be the first option of treatment for patients who are unable to withstand surgery. It may also be used to limit the spread of the cancer in some patients and treat patients who still have some cancer even after the surgery.
It is still an experimental treatment option. It is the removal of a diseased or cancerous patch of skin by freezing it.
This is when some patients are encouraged to join programs that test and study how well a new treatment for a disease works. This might be the best solution for some patients.
What is the outlook for patients with sebaceous cell carcinoma?
With adequate treatment, sebaceous cell carcinoma is not fatal for many people with the disease. The prognosis increases as well for patients who begin the treatment early. Sebaceous cell carcinoma, however, can prove fatal when it spreads to other body tissues. The cancer can also come back in some individuals after treatment. It is very important to receive follow-up care so that any signs of the cancer return can be detected and treated immediately.