Unusual Presentation of Ulcerative Postauricular Swelling as Sebaceous Cell Carcinoma

Sebaceous glands have high concentration over head and neck region. Despite high concentration, sebaceous cell adenoma and carcinomas are infrequent. Sebaceous cell carcinoma is an uncommon, cutaneous aggressive tumor arising from the sebaceous glands and seen almost exclusively on the eyelids (75%). It accounts for just 0.2–0.7% of all eyelid tumors in the USA and very few cases that have originated in areas other than the eyelids have been reported. A 67-year-old male presented with swelling (3 cm × 4 cm), on the right postauricular region, since about 1-month. The swelling became ulcerative and associated with progressive tinnitus and hoarseness of voice. The patient was investigated. Fine-needle aspiration cytology suggested sebaceous cell carcinoma. Then excision biopsy was done, and histopathological examination of excised tissue confirmed the diagnosis. Extraorbital sebaceous cell carcinoma is an aggressive and invasive malignancy. It clinically mimics other diseases and is difficult to diagnose. Hence, an accurate and prompt diagnosis is crucial because of its fulminant course, serious associations with Muir-Torre syndrome and high potential for regional and distant metastasis.