Sebaceoma

A 50-year-old male patient presented with a history of a small, yellowish papule on the right temporal scalp persisting for 5 years. He had undergone an excision biopsy which was reported as squamous cell carcinoma in a private histopathology lab. The patient brought the histopathology block and slide sections to us for second opinion. The slide was reviewed at our hospital with a differential diagnosis of squamous cell carcinoma and benign appendageal tumor. Histopathological examination revealed a well-circumscribed nodule arising from epidermis composed of mature sebocytes with abundant clear cytoplasm and central round nucleus. These sebocytes were admixed with basaloid cells [Figure 1a and b]. There was no evidence of mitosis, dysplasia, or necrosis [Figure 2a and b]. A diagnosis of sebaceoma was made based on the histopathological findings and the patient was reassured regarding the benign nature of the lesion. Sebaceoma usually presents as a deep nodule in the head-and-neck area. The nodule is not clinically distinctive except for a yellow color and requires histopathological examination for confirming the diagnosis. Often, complete excision of sebaceoma is required to exclude the possibility of basal cell carcinoma with sebaceous differentiation.

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Figure 1:

(a) Section shows a well-circumscribed tumor arising from the overlying epithelium. The lesion is comprised of nests and lobules of vacuolated tumor cells admixed with basaloid cells (hematoxylin and eosin stain, ×40). (b) Section highlights the circumscription of the tumor in the deep dermis (hematoxylin and eosin stain, ×100).

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Figure 2:

(a) Section highlights the higher magnification of the tumor cells exhibiting no evidence of nuclear atypia or mitotic activity (hematoxylin and eosin stain, ×400). (b) Section highlights the lobular architecture of tumor cells with delicate vasculature and circumscription (hematoxylin and eosin stain, ×200).

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