Sebaceous carcinoma. Tumors of the sebaceous glands Carcinoma of the sebaceous glands of the eyelid

Cancer is the rarest malignant skin neoplasm. sebaceous glands... This dangerous and insidious symptomatology of the disease requires a special attitude towards itself and the ability to determine it in time in order to begin adequate and timely treatment.

It is generally accepted that the development of cancer of the sebaceous glands is caused by organ defects that occur in both men and women over the age of 50. The affected areas on the skin look like dense nodules with small ulcers, the diameter of which can be up to 50 mm. With cancer of the sebaceous glands of the eyelid region, metastases may occur, while in other places of the development of the disease, metastases are extremely rare. Due to inadequate treatment of tumor formation, relapses of the disease may occur.

Sebaceous gland cancer has a lobular structure, where each lobule is different in size and shape. Between each other, each lobule is separated by a connecting layer. The cells of the lobes are large, have indistinct boundaries. Cell nuclei are elongated or oval. The center of the cell contains a large amount of neutral fat.

With the development of the tumor, the normal maturation of the sebaceous gland is disrupted, the formation grows to the surrounding tissues. The presence of individual tumor elements at a considerable distance from the central part of the tumor process may indicate invasive growth. Unlike benign tumors, cancer of the sebaceous glands has a clear degree of differentiation of cells that have the correct shape and clear boundaries.

Carcinoma is a common malignancy of the sebaceous gland. This pathology often appears from the sebaceous gland of the eyelid, although it can also develop from other sebaceous glands. In most cases, carcinoma occurs on the neck and head.

Statistically, carcinoma occurs in older women as a painful, hard, yellow-red nodule located on the surface of the upper eyelid. Often, carcinoma is mistaken for a malignant neoplasm, which causes a late diagnosis of cancer.

A feature of carcinoma is its tendency to metastasis and recurrence. In almost one third of patients after surgery, carcinomas can recur. Metastases will help to appear in regional lymph nodes... In some cases, the tumor may grow into the orbit.

With the ocular localization of the disease, an increase in the size of the tumor and an untimely diagnosis can be fatal. Carcinoma of the sebaceous gland of the lower eyelid region has a more favorable prognosis, however, when both eyelids are involved in the tumor process, there is also a high probability of mortality.

If carcinoma of the sebaceous gland is combined with malignant formations in the gastrointestinal tract, diagnosis and treatment requires a special approach, since there is a risk of developing complex syndromes in treatment, in particular genodermatosis.

Treatment for sebaceous gland cancer is based on application surgical method by removing the affected area and part of healthy tissue. Since there is a possibility of recurrence of cancer of the sebaceous gland after removal of the affected areas, the so-called micrographic surgery is used. If patients refuse to conduct surgical operation or there are contraindications for anesthesia, radiotherapy can be used as an alternative. The chemotherapy method is highly effective, however, as in the treatment of other types oncological diseases, it has a number of serious consequences for the body. Other methods are used to treat sebaceous cancer.

Due to the fact that the course of cancer of the sebaceous glands is aggressive, patients should be monitored by an oncologist for several years, which will prevent the development of local relapses and distant metastasis.

Seborrheic carcinoma (this: cancer of the sebaceous glands) is a rare malignant tumor, histogenetically associated with unchanged sebaceous glands, their malformations and adenomas.

Etiology of sebaceous gland cancer unknown. Its development, unlike such frequent tumors of the eyelids, such as basal cell carcinoma and squamous cell carcinoma of the skin, is not associated with exposure to UV radiation. At the same time, it is noted that in some cases, cancer of the sebaceous glands occurs as a result of radiation therapy of benign and malignant tumors head and neck (e.g. cavernous hemangioma or retinoblastoma). The development of cancer of the sebaceous glands of the eyelids against the background of chalazion, caused by inflammation of the meibomian glands or Zeiss glands, is associated with the carcinogenic effect of the oleic acid contained in it. The development of cancer of the sebaceous glands can also be associated with the intake of thiazide diuretics - photosensitizers that induce gene mutations in the skin under the influence of ultraviolet radiation; in addition, it has been proven that the interaction of thiazides with nitrites of gastric juice produces carcinogenic nitrosamines. Cancer of the sebaceous glands in Muir-Torre syndrome is associated with the familial cancer syndrome Lynch P. Muir-Torre syndrome is an autosomal dominant genodermatosis characterizing the association of tumors of the sebaceous glands (adenomas, epitheliomas and cancer of the sebaceous glands) with keratoacanthoma and malignant neoplasms internal organs... Usually (63% of cases) tumors of the sebaceous glands with this syndrome occur before or simultaneously with malignant tumors of internal organs. The most frequently affected gastrointestinal tract (in about 51% of cases, the colon and rectum), the genitourinary organs, the region of the head and neck, the blood system. A rather low degree of malignancy of tumors determines a relatively high life expectancy of patients with Muir-Torre syndrome. Human papillomavirus DNA and overexpression of the p53 gene were detected in sebaceous gland cancer tissue.

Sebaceous gland cancer are the most common and are distinguished by the most aggressive course and high potential for metastasis. They usually occur in the tarsal meibomian glands (51%) and Zeiss glands (10%), while upper eyelids are affected 2-3 times more often than the lower ones, which is associated with a large number of meibomian glands in the upper eyelid. In relation to cancer of the sebaceous glands of the eyelids, the frequency of similar cancer of the lacrimal meatus is 11%, cancer of the sebaceous glands of the eyebrows - 2%, other localizations in the orbital region - 0.2-0.8%.

Sebaceous gland cancer develop in persons 6-7 decades of life and very rarely in young children. Women are more often affected.

Clinical manifestations of these tumors extremely diverse, but the most common is a painless, slowly growing yellowish-white knot in the tarsal part of the eyelids. The skin over the tumor is atrophic, hair (eyelashes or eyebrows) is absent. After a while, it erodes and ulcerates with the formation of a crater-shaped ulcer with hardened edges.

Sebaceous gland cancer extraocular localization is quite rare; in the general structure of cancer of the sebaceous glands, its frequency is about 25%. Extraocular cancer of the sebaceous glands, in contrast to the eye cancer, is more common in men and is located in the head and neck region - in the areas where the bulk of the piloseborrheic complexes are concentrated. Up to 20% of cases of cancer of the sebaceous glands are lesions of the head and neck area; cancers of the sebaceous glands of the labia majora, penis, trunk and extremities are less common. Sebaceous gland cancer is observed in 1/3 of patients with Muir-Torre syndrome.

The clinical picture of seborrheic carcinoma uncharacteristic. Extraocular cancer of the sebaceous glands is manifested by a painless dense dermal nodule of pink or yellow-red color, which after a while ulcerates with the formation of a crate-like ulcer with dense edges. Ulceration is accompanied by bleeding in 30% of cases. The tumor is capable of recurrence and metastases to regional lymph nodes.

Atheromas are usually called tumor-like formations that arise due to the fact that there is a blockage of the sebaceous gland, although this class of tumors also includes other skin cysts of different etiologies. It is extremely rare, but skin atheroma can transform into a malignant tumor, therefore its timely diagnosis and treatment is very important for the patient's health. In addition, skin atheromas can be quite painful, carry the risk of infection, therefore, require careful attention from a dermatologist.

Atheroma of the skin got its name from the Greek words meaning "tumor" and "gruel", since it is a rounded formation in the form of a capsule filled with a thick yellowish or white mass with unpleasant odor... This mass is a protein called keratin, which is produced by the capsule walls. Skin atheroma is more common in middle-aged women, although it can also affect men. The reasons for its development have not yet been identified, although some scientists are inclined to the idea of \u200b\u200ba hereditary predisposition.

Atheroma of the skin is considered a tumor-like formation, an epithelial cyst, which is formed as a result of blockage of the sebaceous gland - its excretory duct. Depending on the histological structure these can be retention, epidermal, trichilemmal cysts, multiple steatocystomas, but according to their own clinical manifestations they practically do not differ, and therefore all of them are called skin atheromas.

The main symptoms of skin atheroma and possible complications

Most often, atheroma of the skin occurs on the scalp, on the face, back and neck, in the groin area - where there are a large number of sebaceous glands. Blockage of the sebaceous gland is rarely a single formation, usually skin atheromas are multiple - there can be more than ten of them in one patient.

At the doctor's appointment, patients complain of a tumor that has appeared under the skin, which can shift under the finger and has a dense structure. The skin over the atheroma, as a rule, is not changed, but in case of inflammation it turns red, and with the rapid growth of the formation, it ulcerates, and the point where the sebaceous gland is blocked appears in the center.

Atheroma of the skin can remain small for life or begin to increase in size, be under the skin or have an excretory duct on its surface.

A complication of the disease can occur when the focus of atheroma of the skin is injured, as well as when immunity is reduced, personal hygiene is not observed, in patients diabetes mellitus... In this case, suppuration of atheroma occurs, the skin turns red, swells, the focus of inflammation hurts and increases in size. If you do not take therapeutic measures on time, purulent inflammation can spread to the surrounding tissues, and then the formation of abscesses, the development of phlegmon is likely. There is a rupture of a festering cyst into the subcutaneous tissue. Such complications of the sebaceous gland blockage often leave rough scars after treatment. In addition, with strong suppuration of the focus, it is not always possible to completely remove the capsule of the skin atheroma, and this can further provoke relapses of the disease.

In order to prevent a serious complication of skin atheroma, all inflamed elements need to be sanitized surgically - open and drain abscesses. Sometimes, in order to cope with the effects of inflammation, a course of antibiotics is prescribed.

Treatment of atheroma of the skin and features of postoperative rehabilitation

It is possible to treat atheroma of the skin only surgically, since the only way to get rid of the blockage of the sebaceous gland is to remove the entire tumor along with the capsule in which it is enclosed.

When removing skin atheroma, local anesthesia is performed, then an incision is made over the tumor about 3-4 mm in size, through which the entire tumor is either excreted without opening, or its contents are removed first and then the capsule itself (in this case, a minimal incision is needed). The incision is made along the lines of force and closed with a cosmetic suture or plaster. Methods of removing skin atheroma using biopsy instruments are described - a round area of \u200b\u200bskin with a diameter of about 5 mm is removed above the atheroma and a capsule is removed, and then the wound is sutured.

Removal can be carried out both with a scalpel and using a radio wave knife or a laser beam. In the case of radio wave and laser exposure, the removal of skin atheroma occurs with little trauma, without bleeding (since the vessels are immediately sealed) and with a minimal risk of wound infection).

The result of the operation depends on whether the capsule is completely removed, whether the operation technique has been followed, whether the wound is properly closed, as well as from the characteristics of the patient's skin and his observance of postoperative recommendations not to wet the wound for two days, treat it with an antiseptic daily, and protect it from injury.

Sebaceous carcinoma Is aggressive, but rare view skin cancer. It usually affects the eyelid area, but it can develop in any other place, since sebaceous glands present throughout the body. This type of cancer is often mistaken for other, less serious conditions.

Carcinoma - this is malignant neoplasmwhich is formed from epithelial cells. Due to malignancy, it can spread to surrounding tissues, and in later stages - through lymphatic system or the circulatory system - and to other organs and parts of the body.

The sebaceous glands are found in the dermis, or the middle layer of the skin. They secrete sebum, an oily substance that softens skin and hair. These glands can easily become clogged with dried sebum, dirt or bacteria, which in turn can lead to the formation of hard nodules on the skin's surface, which are often painless but noticeable. Sebaceous carcinoma also causes similar hard and painless nodules to form on the skin, but these nodules are actually malignant tumors.

The most common site for these tumors to form is the inner lid, as this area contains many sebaceous glands.

Also, carcinomas of the sebaceous gland are usually characterized by bulge and extreme vascularity, i.e. the presence of many blood vessels... Correct diagnosis of this disease may require biopsy. As the tumor grows in size, it can become pigmented, usually acquiring a yellowish tint. This staining occurs due to the attachment of lipids to the tumor as it extends beyond the dermis into the epidermis. The tissue around the tumor usually becomes red and inflamed.

How is sebaceous carcinoma treated?

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Sebaceous carcinoma can be removed with surgery, but it may also require more aggressive cancer treatments. Radiation therapy or chemotherapy is usually recommended for patients, especially in the advanced stages of the disease. Carcinoma of the sebaceous gland has a very high level mortality due to the high probability of metastasis.

This type of cancer is most common among the elderly, as well as young people with other eye abnormalities such as retinoblastoma. Moreover, women are more susceptible to its development. It is much rarer than its related basal cell carcinoma.

Sebaceous carcinoma can also be a sign of Muir-Torr syndrome. Patients with this syndrome have several cancerous skin tumors in various places in the body, including the sebaceous glands. The colon and kidneys are among the most common areas of the body that are associated with additional tumors in Muir-Torr syndrome. Thus, in the case of a carcinoma of the sebaceous gland, patients should be examined for other malignant tumors and be observed by a doctor to be sure that there is no Muir-Torr syndrome.

Most often, there are 3 types of oncological pathology on the skin: basal cell skin cancer, squamous cell skin cancer and melanoma (in descending order of frequency). There are also quite rare diseases like Kaposi's sarcoma or Merkel's carcinoma, dermatofibrosarcoma, carcinoma of the sebaceous glands, and others, which are countless.
About 40% to 50% of fair-skinned people who live over 65 will develop at least one skin cancer. Learn to define early signs... Skin cancer can be cured if it is found on early stage and treatment was started.
Skin cancer can appear out of nowhere, or grow out of precancerous skin conditions. Precancerous diseases are referred to as benign tumorsthat turn into cancer over time. In addition, there are a number of diseases that turn into melanoma, which also have a characteristic appearance. Photos of precancerous diseases are mainly found in the article initial stage skin cancer.

On this page, only the main types of skin cancer are mentioned and their photos are shown:

Basal cell skin cancer.

Basal cell skin cancer (basal cell carcinoma) occurs most often. Usually, he is not dangerous. Since it is easy to treat, it grows for a long time, practically does not give metastases. However, there are varieties of basal cell skin cancer (see photo) with blurred boundaries, fuzzy kennels, and simply, similar to completely different diseases. Due to their invisibility, they can gradually grow to very large sizes, penetrate into the bones, ear, eye socket, cartilage, and nerves. It is often impossible to remove such basal cell carcinoma. As you can see in the photo, skin cancer of the basal cell variety takes various forms... These can be light pearlescent or, as it were, cones made of wax. Often with a visible pattern of blood vessels. Ears, neck, and face are favorite spots to appear. Tumors can appear as flat, scaly, flesh-colored, or brown spots on the back or chest. Less commonly, a pale waxy scar.

In the photo there is a superficial basal cell skin cancer, initial stage... It has characteristic external features: slightly raised ridge-like edges with a pearly sheen.

Basal cell skin cancer of the nodular variety. The photo shows characteristic symptoms: dilated vessels, pearlescent sheen, small bloody crusts.

Photo of basal cell skin cancer of the pigmented variety. Has dark blotches, which makes it look like melanoma.

In the photo, skin cancer (second stage basalioma) of a sclerosing variety, looks like a scar. It is very dangerous due to the lack of expression of manifestations, an imperceptible course. And at the same time, it gives a large number of relapses, grows deeply.

Squamous cell skin cancer, photo, signs.

Squamous cell carcinoma of the skin can be similar to melanoma, especially non-pigmented.
The tumor is quite dangerous due to the high growth rate and the possibility of metastases. There can be various manifestations of highly differentiated and poorly differentiated cancer. Highly differentiated heals better, grows longer. As can be seen in the photo, skin cancer with high differentiation, more often has horny masses on the surface, is denser, bleeds less often and practically does not hurt. Poorly differentiated grows much faster, often gives metastases and relapses, is treated worse. In the photo, skin cancer with low differentiation looks like a bleeding nodule, sometimes with bloody, but not corneous (yellow dense) crusts, soft to the touch.
The disease usually presents as a hard red knot. Scales and crusts may appear on the surface of the tumor, it may hurt, bleed. Most often, as seen in the photo, squamous cell skin cancer appears on the nose, forehead, ears, lower lip, hands and other exposed areas of the body. The disease is completely curable if diagnosed and treated at an early stage. If the tumor is large, the effectiveness of treatment will depend on the stage of the cancer.

Squamous cell skin cancer pictured (second stage). On the temporal region in the form of a weeping ulcer with a vitreous surface. The outlines are uneven, indistinct. Separate bloody crusts are visible.

Multiple highly differentiated skin cancer with yellow corneous crusts. Tight to the touch. Not growing so fast. Usually, it develops from actinic keratosis.

The photo shows a dense focus of squamous cell skin cancer on the lower leg. In appearance, it resembles a keratoacanthoma. The crusts on the surface show signs of horny and bloody at the same time.

In the photo, skin cancer of two varieties at once: basalioma on the nose of an early stage and squamous cell on the cheek on the left. There is a scar on the back of the nose from previous surgical treatment.

Warty carcinoma.

Warty carcinoma is a special type of squamous cell skin cancer (see photo). Characterized slow growth, rarely metastases. Unlike classic squamous cell carcinoma, sunlight is not seen as the main cause. On the other hand, the influence of the human papillomavirus is more pronounced. Three variants of the disease associated with anatomical regions have been described: flowering oral papillomatosis in the oral cavity, Buschke-Levenshtein tumor in the genitals and anus, plantar verrucous carcinoma (carcinoma cuniculatum) on the surface of the palms and soles.
Plantar verrucous carcinoma is the most common verrucous type of squamous cell skin cancer. In the photo and in life, it usually affects the plantar surface of the feet and hands. Common in older men. The initial lesion in the form of a nodule with a horny surface is very similar to a plantar wart. In this regard, the correct diagnosis is not made immediately. It is possible to invade the underlying tissues, including tendons, muscles, bones in later stages.

Third stage warty carcinoma of the lower third of the leg and foot. Papillary growths with a large number of yellow corneous crusts are visible. It grows relatively slowly.

Plantar verrucous carcinoma. The diagnosis was not established at the initial stage due to the pronounced similarity with a wart.

Melanoma of the skin. Not cancer, but worse.

Melanoma is the worst predicted. It is with her that many tales and urban legends are associated with the danger of removing moles. You can even die from a very small tumor, because of the high probability of metastases, even after timely surgical removal (and any treatment). Melanoma ranks third among skin cancers. There are several types of moles that develop into melanoma. There is also a group of early forms of melanoma, some of which have existed for many years. In more detail about the precursors of melanoma, including, in the photo - early signs of skin cancer. Possible signs melanomas involve change appearance moles or the uniformity of its color. It is necessary to see a doctor (oncologist, dermatologist, surgeon) if a mole changes its size, shape or color, has uneven edges, irregular shape, itches, oozes, or bleeds.

Nodular melanoma has a glossy sheen, raised in the center, in contrast to the pigmented variety of basal cell skin cancer. The photo also looks like a traumatized angioma.

Superficial melanoma of the skin. Has an uneven color, indistinct contours. It looks almost indistinguishable from a dysplastic nevus. Any skin lesions like this must be removed.

Merkel cell carcinoma.

Merkel cell carcinoma, also called neuroendocrine skin cancer. It is a rare and very aggressive neoplasm that emerges from Merkel cells. Merkel cells in the skin perceive pressure, touch, being mechanoreceptors. The polyoma virus (not papilloma!) Of Merkel cells makes a certain contribution to the development of this type of malignant formation.
The tumor appears as a lump in the skin of a purple or flesh-colored skin (see photo). Skin cancer grows rapidly, rising above its surface, painless when pressed. At the same time, ulcers and erosions are not observed on the surface of Merkel cell carcinoma. Just on large tumors ulceration appears.

Merkel cell carcinoma. Skin cancer from mechanoreceptors. In this photo, it looks like a red bump with an uneven color, small crusts on the surface.

Kaposi's sarcoma on the skin.

Kaposi's sarcoma is a malignant formation characterized by multifocal lesions of the skin, mucous membranes, which may be accompanied by invasion into the vessels. It is the most common sarcoma (not cancer) of the skin. Endothelial cells of lymphatic vessels, smooth muscles vascular wall and dendritic cells of the skin - the source of the appearance of the tumor. Herpes viruses of type 8 and immunodeficiency play an important role in the development of neoplasms. Kaposi's sarcoma has various external manifestations with varying frequencies around the world. Most often it looks like purple plaques, papules, nodules, multiple. Usually, the disease begins with a lesion in the legs, often combined with similar rashes on the oral mucosa (see photo). Although it is not classified as skin cancer, it does not become a mild disease from this.

Kaposi's sarcoma in the form of a variety of purple-violet rashes, growths, small bumps on the back of the foot.

Photograph of Kaposi's sarcoma, manifested as many tiny papules and small nodes on the plantar surface of the foot.

Sebaceous gland cancer (seborrheic carcinoma).

Seborrheic carcinoma is a rare skin cancer arising from the sebaceous glands. This is a rather dangerous tumor with aggressive biological behavior. Most often it appears on the eyelids, scalp, face, where the sebaceous glands are numerous. However, this type of skin cancer can appear almost everywhere. Seborrheic carcinoma of the eyelids develops from altered sebaceous glands called meibomian glands. It can rarely be reborn from a seborrheic nevus. Due to its similarity with a disease such as chalazion or chronic conjunctivitis, the diagnosis can be made with a delay. This skin cancer (photo below) is represented by a yellow or pink lump or lump with dilated vessels. The tumor grows slowly and over time turns into large masses with an ulcerated surface, bleeds easily.

In the photo, skin cancer from the sebaceous glands (seborrheic carcinoma). It appears as a red knot on upper eyelid, dense, almost painless. It is rare.

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