Case series and considerations in the approach of sebaceous carcinoma: clinical and histopathological high-risk factors and proposal of a histopathologic report guideline

Verónica Palacio-Aragon, Department of Dermatology, Fundación Universitaria de Ciencias de la Salud, Hospital de San José de Bogotá, Bogota, Colombia
María J. Sanchez-Zapata, Department of Dermatology, Universidad El Bosque. Bogota, Colombia
Paula A. Dubeibe, Department of Dermatology, Fundación Universitaria de Ciencias de la Salud, Hospital de San José de Bogotá, Bogota, Colombia
Fernando Bulla-Alcalá, Department of Dermatology, Universidad El Bosque. Bogota, Colombia
Miguel Olmos-Pérez, Department of Dermatology, Fundación Universitaria de Ciencias de la Salud, Hospital de San José de Bogotá, Bogota, Colombia

Background: Sebaceous carcinoma (SC) is a rare, aggressive tumor often misdiagnosed due to variable presentation. Objective: The aim of this study was to describe clinical and histopathological features of SC, identify high-risk factors for adverse outcomes, and propose a standardized pathology report. Methods: This was a case series of 15 patients in Bogotá, Colombia. Results: Histological evaluation revealed diverse differentiation patterns, with key prognostic features including perineural invasion, pagetoid spread, and high Ki67 proliferation index. Mohs micrographic surgery was the most frequently used treatment. Only one recurrence was observed. Conclusions: Functional and histological heterogeneity in SC highlights the need for standardized reports to guide treatment and improve outcomes.

Keywords: Sebaceous gland neoplasms. Eyelid neoplasms. Muir-Torre syndrome. Mohs surgery. Skin neoplasms.