Superficial epithelioma with sebaceous differentiation (SESD) is a

A Rare Case of Superficial Epithelioma
With Sebaceous Differentiation
Ian Mukand-Cerro MD2 , Michelle Chevalier MD1, Marier Hernandez-Perez MD1
1
Miraca Life Sciences Research Institute, Irving, TX; 2Tufts Medical Center, Department of Pathology and Laboratory Medicine, Boston, MA
Background
Discussion
Superficial epithelioma with sebaceous
differentiation (SESD) is a rare benign
sebaceous neoplasm, with approximately
ten cases reported in the literature. It
most commonly occurs on the face, but
has also been reported on the trunk and
extremities. The mean age of onset is 60
years, and there is no gender predilection.
We report a case of a 78-year-old man
with SESD of the left lower back.
Superficial epithelioma with sebaceous
differentiation is a benign entity that has
distinct histopathological features but a
3
nonspecific clinical appearance . In the
present case, the lesion was pigmented,
which was concerning for a possible
melanoma.
A
Case Report
A 78-year-old man presented with a
darkly pigmented papule on the left lower
back which was clinically concerning
for a pigmented basal cell carcinoma or
melanoma.
A superficial shave biopsy of the lesion
demonstrated a plate-like endophytic
proliferation of basaloid and squamous
cells displaying broad epidermal
attachments. There was an admixture
of mature sebocytes, horn cysts, and
pigmented keratinocytes. No peripheral
palisading, retraction artifact, or mitotic
activity was identified. The diagnosis
rendered was a superficial epithelioma
with sebaceous differentiation.
B
C
D
Figure A: Shave biopsy of the skin demonstrates a
plate-like endophytic proliferation of basaloid cells
with broad attachments to the epidermis (H&E, 2).
B: The lesion displays prominent acanthosis and
pigmented keratinocytes (H&E, 10X). C-D: A higher
power view demonstrates an admixture of basaloid
cells, sebocytes, and horn cysts (H&E, 10X).
The histopathological features of
SESD can be differentiated from other
sebaceous neoplasms. The lesion has a
plate-like endophytic architecture with
broad attachments to the epidermis.
Numerous horn cysts are present,
1, 2
characteristic of SESD . There is also
a variable component of basaloid
and sebaceous cells. There is a lack of
peripheral palisading and retraction
artifact, distinguishing SESD from
basal cell carcinoma with sebaceous
1
differentiation . In sebaceous adenoma/
sebaceoma, the basaloid cells tend to
locate at the periphery at the tumor while
the sebaceous cells are at the center. In
addition, there are no horn cysts and
pigmented keratinocytes in sebaceous
adenoma/sebaceoma. SESD has not been
described in association with Muir-Torre
1
syndrome . The clinical course of SESD
is benign, with no cases of recurrence or
1
metastasis after excision .
References
1. Lee, MJ. A Case of Superficial Epithelioma with Sebaceous Differentiation. Yonsei Medical Journal
2003;44:347-350.
2. Rothko, K et al. Superficial Epithelioma with Sebaceous Differentiation. Archives of Dermatology
1980;116:329-331.
3. Vaughan, T et al. Superficial epithelioma with sebaceous differentiation. Journal of the American
Academy of Dermatology 1990;23:Number 4, Part 1.
4. Shalin et al. Sebaceous neoplasia and the Muir-Torre syndrome: important connections with clinical
implications. Histopathology 2010;56(1): 133-147.
Pursuant to 45 CFR 46, section 101b (4) – research was reviewed by Miraca Life Sciences Research Institute IRB.