Locally Aggressive and Multicentric Recurrent Extraocular Sebaceous Carcinoma: Case Report and Literature Review

Objective: Sebaceous Carcinoma is a rare and aggressive malignant tumor. We present a case report of a large truncal tumor with multicentricity and aggressive locoregional recurrence that required trapezius myocutaneous flap reconstruction. Examining patterns of multicentricity, metastasis, and recurrence of sebaceous carcinoma in the literature we sought to explore potential reasons behind the aggressive behavior. Methods: Retrospective chart review was used to analyze the case in detail. Preoperative workup, intraoperative details, pathology, and follow-up visits were reviewed. Selected literature was considered with series of 5 or more patients. Results: The recurrent tumor was resected with negative margins leaving a defect of 14 × 7 cm(2) that was covered with a trapezius myocutaneous flap. Postoperative hospital course was uneventful with no further local recurrence. On follow-up visits, tumors at other sites have been discovered. Reported rates of multicentricity, metastasis, and recurrence vary widely in the literature, but both subtypes of sebaceous carcinoma behave aggressively. Conclusions: A combination of genetic predisposition, delayed definitive care, and inherent tumor biology led to the aggressive locoregional disease in this case.