is Sebaceous Carcinoma?
Sebaceous carcinoma (SC) is a rare type
of skin cancer. It only develops on skin that has sebaceous glands.
These glands, which help keep our skin moist, are found throughout
the body. They are most plentiful around the eyes.
About 75% of SCs develop on an eyelid. The face and neck also
contain many sebaceous glands, and this is where most other SCs
develop. SC also can develop on the torso, leg, arm, inside the
mouth, in the ear, on the genitals, and even on top of the big toe.
What Causes Sebaceous Carcinoma?
Scientists believe that the sun plays a key role in causing SC.
Having a weak immune system or receiving radiation treatments for a
medical condition also seems to increase the risk of developing SC.
Who Gets Sebaceous Carcinoma?
Anyone can develop SC, but some people have a greater risk:
Middle age or older. It is
very rare for SC to develop before 30 years of age. Most people
are 60 years of age or older, and the risk continues to increase
Weakened immune system.
People who have a weakened immune system have a much greater
risk. A weakened immune system may be caused by a medical
condition or medication. Medical conditions that weaken the
immune system include human immunodeficiency virus (HIV) and
cancer. Medication taken after transplant surgery to prevent the
body from rejecting the new organ and some medications used to
treat psoriasis or arthritis also weaken the immune system.
Received radiation treatments
for a medical condition. People who received radiation
treatments as a child have been diagnosed with this rare skin
cancer in their 60s and 70s. SC also develops in children who
receive radiation treatments for retinoblastoma, a cancer that
develops in the eye.
Muir-Torre syndrome (MTS).
This is a rare medical condition. People get MTS from the genes
that they inherit from their parents. MTS greatly increases the
risk for developing several cancers. The risk is greatest for a
type of colon cancer. Other cancers that a person with MTS has
an increased risk of developing are SC, cancers of the uterus,
stomach, ovaries, intestine, urinary tract, liver, and bile
SC is often the first sign that a person has MTS.
Signs and Symptoms of Sebaceous
SC often appears as a small, slowly growing, firm, deep-seated mass
on the upper eyelid. SC is 2 to 3 times more common on the upper
eyelid than on the lower eyelid. It tends to look like a sty and to
As the cancer progresses, the affected eye may look like a person
has a case of pink eye. Left untreated, SC can cause the affected
eyelid to turn inward or outward. The eyelashes may fall out, and
the person’s eyesight may become distorted.
When SC develops elsewhere on the body, the skin cancer looks like a
slowly growing mass that is pink to reddish yellow in color. The
mass may bleed.
How is SC Diagnosed?
When a dermatologist suspects skin cancer, the dermatologist
performs a biopsy. This procedure can be safely performed during an
office visit. To perform a biopsy, the dermatologist will remove the
suspicious lesion, or part of it, so that it can be examined under a
microscope. This is the only way to know whether a patient has skin
If the biopsy confirms that the patient has SC, the dermatologist
Perform a full-body skin
examination to check for other skin cancers and check the
patient’s lymph nodes for swelling.
Ask if the patient or anyone in the
patient’s family has MTS.
Request that the patient have a
thorough eye exam from an ophthalmologist if the SC occurs on an
Write orders for additional medical
tests. These tests may include a chest x-ray, blood tests,
urinalysis, and colonoscopy. Women may get an order for a
mammogram. The purpose of these tests is to check for other
cancers that are common in people who have MTS.
Refer the patient to a medical
geneticist. A medical geneticist can provide information about
genetic testing and cancer screenings that may be appropriate.
Treatment for Sebaceous Carcinoma
A dermatologist considers many factors before determining which
treatment will be best for the patient. These factors include the
patient’s age, health, and where the SC is located on the body.
Treatment options for SC include:
Mohs micrographic surgery (Mohs).
Mohs allows the surgeon to remove one layer of skin at a time.
Each layer that is removed is placed under a microscope so that
the surgeon can look for cancer cells. This process continues
until the surgeon no longer finds cancer cells. Mohs often can
be performed in a dermatologist’s office while the patient
Excision. Mohs may not be
appropriate for every patient. If a tumor is large, SC may be
treated with a surgical procedure called “excision.” This
involves surgically removing DFSP and a portion of
normal-looking skin. This procedure may be performed in a
dermatologist’s office. Sometimes it needs to be performed in an
Lymph node dissection. If
the cancer has spread to nearby lymph nodes, the lymph nodes may
be surgically removed.
Radiation. This treatment is
usually only an option when a patient cannot have surgery. If
the cancer has spread to other parts of the body, radiation may
be part of the treatment plan. It can help kill cancer cells and
When detected early, survival rates are good for people who have SC.
But SC can return or spread to other areas of the body, so follow-up
is essential. The dermatologist will tell you how often you should
return for check-ups. It is essential to keep all of these
Sebaceous Carcinoma: What Does It
Blake PW, Bradford PT, Devesa SS et al. “Cutaneous
appendageal carcinoma incidence and survival patterns in the United
States: a population-based study.” Archives of Dermatology.
June 2010, 146: 625-32.
Martinelli PT, Cohen PR, Schulze KE et al. “Sebaceous
Carcinoma.” In Nouri K. [editor]. Skin Cancer. United States.
McGraw Hill Medical; 2008. p. 240-9.
Nelson BR, Hamlet KR, Gillard M et al. “Sebaceous carcinoma.”
Journal of the American Academy of Dermatology. July 1995;
33: 1-15; quiz 6-8.
content solely developed by the American Academy of Dermatology
This rare type of skin cancer can be mistaken for a sty.
If you have a growth on your eyelid that lasts for more
than 2 weeks, make an appointment to see a
Photograph used with permission of the Journal
of the American Academy of Dermatology.
The photograph was published in the Journal
of the American Academy of Dermatology,
Vol. # 33, Nelson BR, Hamlet KR, Gillard M, et al.
“Sebaceous carcinoma.” 1 - 15. Copyright Elsevier
Journal of the American Academy of