This article will help you read and understand your pathology report for sebaceous carcinoma of the skin.
by Allison Osmond, MD FRCPC, updated on May 14, 2019
The outside of our body is covered in skin. The surface of the skin is called the epidermis. The epidermis produces a material called keratin. The epidermis is waterproof and protects us from toxins and injuries. The tissue beneath the epidermis is called the dermis, it contains blood vessels and connective tissue. Below the dermis is a layer of subcutaneous fat. The epidermis is separated from the dermis and subcutaneous fat by a very thin layer of tissue called the basement membrane.
Located within the dermis and subcutaneous tissue are small structures called adnexa. The adnexa in the skin include follicles that make hair and glands that produce sweat to keep us cool and oil to help keep our skin waterproof.
Sebaceous glands are a type of gland found in the skin adnexa. Sebaceous glands make and secrete a material called sebum which looks and feels like fat. Too much sebum can make our skin and hair feel ‘greasy’. Sebaceous glands can be found all over the body although the greatest number are found in on the face and scalp. There are no sebaceous glands found on the palms of our hands or soles of our feet.
Sebaceous glands are made up of cells called sebocytes. Under the microscope, sebocytes can be seen producing the fat that is used to make sebum.
Sebaceous carcinoma is type of skin cancer. Sebaceous carcinoma develops from sebocytes in the dermis and subcutaneous tissue. One of the most common locations for sebaceous carcinoma is in the skin around the eye. The caner cells produce sebum which often makes the tumour look yellow.
Sebaceous carcinoma is an uncommon type of skin cancer and doctors still do not know what causes most tumours. However, for some patients, previous radiation has been shown to increase the risk for sebaceous carcinoma in the exposed area of the body.
A margin is any tissue that was cut by the surgeon in order to remove the tumour from your body. Whenever possible, surgeons will try to cut tissue outside of the tumour to reduce the risk that any cancer cells will be left behind after the tumour is removed.
Your pathologist will carefully examine all the margins in your tissue sample to see how close the cancer cells are to the edge of the cut tissue. Margins will only be described in your report after the entire tumour has been removed.
A negative margin means there were no cancer cells at the very edge of the cut tissue. If all the margins are negative, most pathology reports will say how far the closest cancer cells were to a margin. The distance is usually described in millimeters.
A margin is considered positive when there are cancer cells at the very edge of the cut tissue. A positive margin is associated with a higher risk that the tumour will recur in the same site after treatment.
Patients with Muir Torre syndrome are at an increased risk of developing sebaceous carcinoma. Patients with Muir Torre syndrome tend to develop multiple sebaceous carcinomas and the tumours are larger than in a patient without the syndrome.
Patients with Muir Torre syndrome also have an increased risk for developing colon cancer.
If you have been diagnosed with multiple sebaceous carcinomas, your doctor may suggest a genetic test to see if you have Muir Torre syndrome.