Sebaceous Carcinoma: An Immunohistochemical Reappraisal

Abstract

The rates of distant metastases and tumor death in sebaceous carcinoma (SC) have been reported to be higher than those of other cutaneous carcinomas, such as squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), regardless of whether they occur in ocular or extraocular regions. Therefore, strict differentiation of SC from SCC and BCC is required. In this article, we report immunohistochemical findings of SC and compare these data to those of SCC, BCC, and sebaceoma. An immunohistochemical study was performed using 7 antibodies [anti-carcinoembryonic antigen (CEA), anti-epithelial membrane antigen (EMA), anti-CA15-3, anti-CA19-9, anti-androgen receptor (AR), anti-epithelial antigen (Ber-EP4), and anti-adipophilin (ADP)] on 35 cases of SC (16 cases in ocular and 19 cases in extraocular regions) and 10 cases of each SCC (5 cases in ocular and 5 cases in extraocular regions), BCC (5 cases in ocular and 5 cases in extraocular regions), and sebaceoma (no cases arose on the eyelids). In summary, the typical immunophenotypes of SC were EMA+, CA15-3+, AR+, Ber-EP4-, and ADP+; those of sebaceoma were CEA-, EMA+, Ber-EP4-, and ADP+; those of SCC were CEA-, EMA+, CA19-9-, AR-, Ber-EP4-, and ADP-; and those of BCC were CEA-, EMA-, CA15-3-, Ber-EP4+, and ADP-. Other antibody tests for each neoplasm were positive in about half of the cases. The detection of AR and ADP was useful for differentiating SC from SCC, whereas the determination of EMA, CA15-3, Ber-EP4, and ADP was valuable in differentiating SC from BCC.

Multifocal Metastasizing Extra-Ocular Facial Sebaceous Carcinoma as Diagnostic Challenge: Case Report and Systematic Review

“…CD 10 is usually absent in SC, which helps in distinguishing it from BCC. Ansai et al [14] showed that positivity for adipophilin is most useful in the diagnosis of sebaceous neoplasms. Anti-AR (androgen receptor) is described as the best marker to differentiate between SC and SCC.…”

“…Differentiation between SC, squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) has been shown to be difficult with routine staining methods [14]. As the treatment of SC differs from the treatment of SCC and BCC [15,16], discrimination remains important and special staining methods are recommended [9,14,17].…”

My Journey into the World of Salivary Gland Sebaceous Neoplasms

“…They also have been found in the adrenal gland and Leydig cells, as well as brown and white fat [59]. These markers are well-characterized in sebaceous skin and eye tumors, with 95-100% of skin and eyelid sebaceous tumors staining with these markers in three recent studies [58,60,61]. However, in the salivary gland, these markers have only been studied in the sebaceous variant of epithelial myoepithelial carcinoma and in one sebaceous carcinoma of the tongue [62,63].…”

Immunohistochemistry in Dermatopathology

“…Ansai et al 1 found that androgen receptor (AR) and adipophilin ( Figure 1) expression supports the diagnosis of sebaceous carcinoma, rather than SCC.…”

“…2,3 Reactivity for adipophilin in sebaceous tumors can also distinguish them from BCC. 1 The utility of Ber-EP4 in this setting is controversial; although BCCs stain positive for Ber-EP4, there is varying literature on its reactivity in sebaceous lesions. 2,4 Adipophilin is a protein on the surface of intracellular lipid droplets and thus shows expression in sebaceous lesions, particularly well-differentiated lesions.…”