Sebaceous Carcinoma

What is sebaceous carcinoma?

Sebaceous (pronounced “suh-BAY-shus”) carcinoma is a rare skin cancer that develops in your skin’s oil-producing glands. “Sebaceous” means oil-producing.

The cancer most commonly affects your eyelids, but can develop almost anywhere on your body. That’s because you have sebaceous glands underneath most of your skin, especially where there’s hair. These glands secrete an oily substance called sebum that protects your body from germs.

Is sebaceous carcinoma aggressive?

Sebaceous carcinoma is an aggressive skin cancer, which means it spreads quickly. Cancer that spreads outside of the original tumor is metastatic cancer.

What are other names for sebaceous carcinoma?

“Carcinoma” is the medical term for cancer. Healthcare providers may also refer to sebaceous carcinoma as sebaceous gland carcinoma or sebaceous gland adenocarcinoma or meibomian (pronounced “my-BOW-me-en”) gland carcinoma. The meibomian gland is a specific sebaceous gland that only exists in your eyelids.

How common is sebaceous carcinoma?

Sebaceous carcinoma is a rare cancer. About 5% to 10% of skin cancers are eyelid tumors. Only around 1% of these cancers are sebaceous carcinoma.

Sebaceous carcinoma mainly affects women and people assigned female at birth and people ages 60 to 80. However, younger and older adults and children can also get this skin cancer.

What causes sebaceous cancer?

Experts don’t know why some people develop sebaceous carcinoma. Like other types of skin cancer, exposure to the sun’s ultraviolet (UV) rays may contribute to this cancer. It may also develop in people, especially younger people, who have had radiation therapy to the head or neck.

What are risk factors for sebaceous carcinoma?

People with a rare inherited disease called Muir-Torre syndrome are more likely to develop sebaceous carcinoma, as well as colorectal (colon) cancer. Muir-Torre syndrome is a form of Lynch syndrome. It causes tumors to form in your sebaceous glands.

Some studies suggest that people of Asian descent are also more at risk.

In addition to age and sun exposure, other risk factors for sebaceous cancer include:

• Weak immune system due to conditions like cancer or HIV and AIDS.
• Organ transplant medications.
• Immune system suppressing medications for arthritis or psoriasis.

What are the symptoms of sebaceous carcinoma?

Sebaceous carcinoma tumors tend to affect your upper eyelids, which have many sebaceous glands. Tumors can also affect your lower eyelids. You may need to pull gently on your eyelid to see the lump.

On your eyelid, you may notice:

• Firm, round, yellow painless bump that resembles a pimple.
• A sore that bleeds, doesn’t heal, or heals and then comes back.
• Thickened, yellow or red crusty skin near your eyelashes.

What are the symptoms of advanced sebaceous carcinoma?

Untreated sebaceous carcinoma can cause:

• Loss of eyelashes.
• Oozing growths on your upper and lower eyelids.
• Reddish eyes that resemble pink eye (conjunctivitis).
• Vision problems.

What other conditions cause bumps on the eyelids?

Sebaceous carcinoma is rare. Still, you should see a healthcare provider if you develop an eyelid growth. Try not to panic. One of these noncancerous (benign) skin conditions is more likely the cause:

• Blepharitis (swollen eyelids).
• Chalazion (eyelid cyst).
• Pink eye (eye infection).
• Stye (oil gland infection).

Where else on the body does sebaceous carcinoma develop?

Sebaceous carcinoma tumors can also appear on your head, ears or neck. Less commonly, tumors form on your back, chest, abdomen, genitals or buttocks.

You should contact a healthcare provider if you notice:

• Changes to a mole or birthmark on your skin.
• New skin growths, including inside of your ear.
• Slow-growing pink or yellow skin bumps that bleed easily.

Where does sebaceous carcinoma spread?

Sebaceous carcinoma is most likely to affect the lymph nodes. These small glands cleanse and remove damaged cells in your lymphatic system.

How is sebaceous carcinoma diagnosed?

A dermatologist (a doctor who specializes in skin conditions) will perform a skin biopsy to remove the growth and check for cancer cells under a microscope.

If the tumor affects your eyelids, you may also see an ophthalmologist (eye doctor) who can perform a biopsy.

How is metastatic sebaceous carcinoma diagnosed?

If a skin biopsy indicates you have sebaceous carcinoma, you may see a team of doctors for diagnosis and treatment. Your provider will take your history and do a physical exam to look for evidence of cancer spread to your lymph nodes or other organs. An ophthalmologist will examine your eye to see if the tumor has extended onto your eye.

How is sebaceous carcinoma treated?

Surgical options include:

• Wide local excision to cut out (excise) the tumor along with a margin of normal surrounding tissue.
• Mohs surgery to remove the cancerous tumor and surrounding healthy tissue (the margin) in stages to ensure all cancer cells are gone. The surgeon takes thin slices of tissue and examines them during the procedure to know if they need to take more tissue.
• Radiation therapy may be done if you’re not a candidate for surgery.

Depending on the extent of the procedure, you may have reconstructive surgery. This procedure can minimize scarring and improve your eyelid function and facial symmetry. Your dermatologist or an oculoplastic surgeon may perform this step at the end of the tumor removal, if needed.

How is metastatic sebaceous carcinoma treated?

Treatments for metastatic sebaceous carcinoma vary, depending on where the cancer spreads. You may have surgery to remove affected lymph nodes. You may also have radiation therapy or other cancer treatments.

Is sebaceous carcinoma fatal?

With treatment, more than 90% of those affected survive the disease. The outlook is better for those who receive treatment within six months.

Sebaceous carcinoma can be fatal if it spreads. Outcomes are worse when there’s a delay in diagnosis and treatment.

What is the outlook for people with sebaceous carcinoma?

Sebaceous carcinoma may be aggressive. For as many as 1 in 4 people, the cancer comes back (recurs) or spreads (metastasizes) after treatment.

It’s important to receive follow-up care so your healthcare providers can watch for signs of the cancer’s return and treat it right away.

You may be able to improve your outlook by:

• Performing regular monthly skin self-exams to quickly detect skin changes.
• Getting more frequent skin exams at your provider’s office.
• Taking steps to minimize sun exposure, such as wearing sunscreen, wide-brimmed hats and UV-protective sunglasses.

What’s the difference between sebaceous carcinoma, sebaceous hyperplasia and sebaceous cysts?

Sebaceous hyperplasia is a noncancerous (benign) growth in a hair follicle. You may have several of these soft moveable bumps. The bumps typically appear on your chin, cheeks, forehead, nose or upper trunk (chest, back and shoulders).

Sebaceous cysts are noncancerous growths that form underneath your skin when dead skin and oil clog a sebaceous gland. Sebaceous cysts move easily under your skin and typically affect your face, neck or torso. Cysts that get large or cause infections may require treatment.

When should I call my provider?

You should call your healthcare provider if you notice:

• A bump or growth on your eyelid.
• New skin growth or changes to moles or birthmarks.
• Skin growths that easily bleed.

What should I ask my provider?

You may want to ask your healthcare provider:

• What caused the skin cancer?
• Am I at risk for other types of skin cancer?
• What’s the best treatment for me?
• Am I at risk for metastatic cancer?
• How often should I get cancer screenings?
• Am I at risk for other types of internal cancer?

A note from Cleveland Clinic

You should contact your healthcare provider anytime you notice changes to your skin. In most instances, these changes are harmless. Still, while many noncancerous conditions cause growths on your eyelids or bumps on your skin, it’s best to see your provider for an exam. Sebaceous carcinoma may be rare, but it’s an aggressive disease that can quickly spread. A prompt diagnosis and treatment plan can significantly affect your prognosis.