Sebaceous carcinoma: evidence-based clinical practice guidelines.
Joshua L Owen, Nour Kibbi, Brandon Worley, Ryan C Kelm, Jordan V Wang, Christopher A Barker, Ramona Behshad, Christopher K Bichakjian, Diana Bolotin, Jeremy S Bordeaux, Scott H Bradshaw, Todd V Cartee, Sunandana Chandra, Nancy L Cho, Jennifer N Choi, M Laurin Council, Hakan Demirci, Daniel B Eisen, Bita Esmaeli, Nicholas Golda, Conway C Huang, Sherrif F Ibrahim, S Brian Jiang, John Kim, Timothy M Kuzel, Stephen Y Lai, Naomi Lawrence, Erica H Lee, Justin J Leitenberger, Ian A Maher, Margaret W Mann, Kira Minkis, Bharat B Mittal, Kishwer S Nehal, Isaac M Neuhaus, David M Ozog, Brian Petersen, Veronica Rotemberg, Sandeep Samant, Faramarz H Samie, Sabah Servaes, Carol L Shields, Thuzar M Shin, Joseph F Sobanko, Ally-Khan Somani, William G Stebbins, J Regan Thomas, Valencia D Thomas, David T Tse, Abigail H Waldman, Michael K Wong, Y Gloria Xu, Siegrid S Yu, Nathalie C Zeitouni, Timothy Ramsay, Kelly A Reynolds, Emily Poon, Murad Alam
Author Information
Joshua L Owen: Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Nour Kibbi: Department of Dermatology, Yale School of Medicine, New Haven, CT, USA.
Brandon Worley: Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Division of Dermatology, The Ottawa Hospital, Ottawa, ON, Canada.
Ryan C Kelm: Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Jordan V Wang: Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, PA, USA.
Christopher A Barker: Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Ramona Behshad: Department of Dermatology, Saint Louis University School of Medicine, Saint Louis, MO, USA.
Christopher K Bichakjian: Department of Dermatology, University of Michigan, Ann Arbor, MI, USA.
Diana Bolotin: Section of Dermatology, The University of Chicago, Chicago, IL, USA.
Jeremy S Bordeaux: Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Scott H Bradshaw: Department of Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, ON, Canada.
Todd V Cartee: Division of Dermatology, Pennsylvania State University, Hershey, PA, USA.
Sunandana Chandra: Division of Hematology and Oncology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Nancy L Cho: Department of Surgery, Brigham and Women's Hospital, Harvard University, Boston, MA, USA.
Jennifer N Choi: Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
M Laurin Council: Division of Dermatology, Center for Dermatologic and Cosmetic Surgery, Washington University in Saint Louis, Saint Louis, MO, USA.
Hakan Demirci: Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, MI, USA.
Daniel B Eisen: Department of Dermatology, University of California Davis, Sacramento, CA, USA.
Bita Esmaeli: Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Nicholas Golda: Department of Dermatology, University of Missouri School of Medicine, Columbia, MO, USA.
Conway C Huang: Department of Dermatology, University of Alabama, Birmingham, AL, USA.
Sherrif F Ibrahim: Department of Dermatology, University of Rochester, Rochester, NY, USA.
S Brian Jiang: Department of Dermatology, University of California San Diego, San Diego, CA, USA.
John Kim: Department of Plastic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Timothy M Kuzel: Division of Hematology, Oncology and Cell Therapy, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA.
Stephen Y Lai: Departments of Head and Neck Surgery and Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Naomi Lawrence: Department of Dermatology, Cooper Hospital, Rowan University, Camden, NJ, USA.
Erica H Lee: Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Justin J Leitenberger: Department of Dermatology, Oregon Health and Science University, Portland, OR, USA.
Ian A Maher: Department of Dermatology, University of Minnesota, Minneapolis, MN, USA.
Margaret W Mann: Department of Dermatology, University Hospital, Cleveland, OH, USA.
Kira Minkis: Department of Dermatology, Weill-Cornell Medical College, New York, NY, USA.
Bharat B Mittal: Department of Radiation Oncology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Kishwer S Nehal: Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Isaac M Neuhaus: Department of Dermatology, University of California at San Francisco, San Francisco, CA, USA.
David M Ozog: Department of Dermatology, Henry Ford Hospital, Detroit, MI, USA.
Brian Petersen: Department of Dermatology, Colorado Permanente Medical Group, Denver, CO, USA.
Veronica Rotemberg: Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Sandeep Samant: Department of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Faramarz H Samie: Department of Dermatology, Columbia University Medical Center, New York, NY, USA.
Sabah Servaes: Department of Radiology, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA.
Carol L Shields: Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, USA.
Thuzar M Shin: Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Joseph F Sobanko: Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Ally-Khan Somani: Department of Dermatology, Indiana University School of Medicine, Indianapolis, IN, USA.
William G Stebbins: Department of Dermatology, Vanderbilt University Medical Center, Nashville, TN, USA.
J Regan Thomas: Department of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Valencia D Thomas: Dermatology and Dermatopathology, Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
David T Tse: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
Abigail H Waldman: Brigham and Women's Hospital Department of Dermatology, Harvard Medical School, Boston, MA, USA.
Michael K Wong: Division of Cancer Medicine, Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Y Gloria Xu: Department of Dermatology, University of Wisconsin-Madison, Madison, WI, USA.
Siegrid S Yu: Department of Dermatology, University of California at San Francisco, San Francisco, CA, USA.
Nathalie C Zeitouni: Department of Dermatology, University of Arizona, Phoenix, AZ, USA.
Timothy Ramsay: The Ottawa Health Research Institute, The Ottawa Hospital, Ottawa, ON, Canada.
Kelly A Reynolds: Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Emily Poon: Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Murad Alam: Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. Electronic address: m-alam@northwestern.edu.
Sebaceous carcinoma usually occurs in adults older than 60 years, on the eyelid, head and neck, and trunk. In this Review, we present clinical care recommendations for sebaceous carcinoma, which were developed as a result of an expert panel evaluation of the findings of a systematic review. Key conclusions were drawn and recommendations made for diagnosis, first-line treatment, radiotherapy, and post-treatment care. For diagnosis, we concluded that deep biopsy is often required; furthermore, differential diagnoses that mimic the condition can be excluded with special histological stains. For treatment, the recommended first-line therapy is surgical removal, followed by margin assessment of the peripheral and deep tissue edges; conjunctival mapping biopsies can facilitate surgical planning. Radiotherapy can be considered for cases with nerve or lymph node involvement, and as the primary treatment in patients who are ineligible for surgery. Post-treatment clinical examination should occur every 6 months for at least 3 years. No specific systemic therapies for advanced disease can be recommended, but targeted therapies and immunotherapies are being developed.
