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Pathology of Sebaceous Gland Tumours

Dr Sampurna Roy MD         


Muir-Torre Syndrome and Sebaceous Tumors [Pathology Infographic]



Sebaceous tumours are relatively rare tumours of the skin.

Cutaneous adnexal tumours with sebaceous differentiation vary from well-differentiated to poorly-differentiated varieties. 

Recognition of these lesions is important: 

-Patients with multiple sebaceous tumours of the skin should be examined for other visceral malignancies, eg. colonic, hematologial, urothelial, kidney, endometrial etc - (Muir-Torre syndrome).

-Sebaceous carcinoma is an aggressive tumour and must be distinguished from epidermal tumours. 

-Sebaceous hyperplasia and Fordyce's spot / Montgomery's tubercle are not true sebaceous neoplasm.

Sebaceous hyperplasia is not associated with Muir-Torre syndrome and must be distinguished from sebaceous adenoma which is often associated with Muir-Torre syndrome.

There is an increasing tendency to regard sebaceoma and sebaceous  adenoma as part of a continuum of benign tumours which some term simply as sebaceous adenoma whereas others have suggested the term sebomatricoma.

Clues to diagnosis:  Presence of sebocytes or tubules resembling sebaceous duct ; vacuolated cells with or without indentation of the nucleus; ductal structures lined by crenulated corneocytes ; holocrine secretion; histochemical demonstration of intracellular lipid .


Additional Reagents Useful in the Differential Diagnosis of Sebaceous Tumors:

Lazar AJF, Lyle S, Calonje E. Sebaceous neoplasia and Torre–Muir syndrome. Current diagnostic pathology 2007;13(4):301-319.

- Oil Red-O: Adipophilic special stain; must have fresh frozen material.

- Adipophilin: Newly characterized antibody against a protein associated with intracytoplasmic lipid vesicles; works on formalin-fixed, paraffin-embedded tumors.

-Epithelial Membrane Antigen (EMA): Highlights mature sebocytes. 

- BerEP4: Seen in most basal cell carcinomas, but is not usually present in sebaceomas.

- Cytokeratin 7 (CK7): Present in most sebaceous neoplasia, usually absent in basal cell carcinoma.

- Use of these antibodies in panels, perhaps including other markers for lesions entering the differential diagnosis in a particular case, is usually more helpful than application of a single immunohistochemical stain.



Muir-Torre Syndrome:  

Muir-Torre syndrome is inherited as an autosomal dominant trait.

This is a variant of the hereditary non-polyposis colonic carcinoma syndrome and is due to mutations of the mis-match repair genes.

The criteria for diagnosis include presence of sebaceous neoplasm (adenoma, sebaceoma and occasionally sebaceous carcinoma) internal malignancy (Example: Colorectal carcinoma).

The sebaceous tumours are often difficult to classify precisely.

The tumours show marked cystic changes.

Recent studies suggest that immunohistochemistry on the sebaceous tumours for mismatch repair genes may identify patients with Muir-Torre syndrome.

Other visceral malignancies have been reported in the larynx, genitourinary tract, ovary and uterus. 

Keratoacanthoma, epidermal cysts and colonic polyps have also been reported in this syndrome.



Ectopic Sebaceous Glands:

Fordyce's spot

Hamartomas and Hyperplasias:

Folliculosebaceous Cystic Hamartoma


Nevus Sebaceous of Jadassohn

Sebaceous Hyperplasia


Sebaceous Adenoma



Sebaceous Carcinoma


Tumours with focal Sebaceous Differentiation:

Basal Cell Carcinoma (the term "basal cell carcinoma with sebaceous differentiation" should be used only for an otherwise conventional basal cell carcinoma with histological evidence of sebaceous differentiation) ;

Squamous Cell Carcinoma ; Seborrheic Keratosis.





Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)






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