Sebaceous carcinoma: controversies and their evidence for clinical practice

Nour Kibbi, Brandon Worley, Joshua L. Owen, Ryan C. Kelm, Christopher K. Bichakjian, Sunandana Chandra, Hakan Demirci, John Yah Sung Kim, Kishwer S. Nehal, James Regan Thomas, Emily Poon Samuelson, Murad Alam*

*Corresponding author for this work

Research output: Contribution to journalReview article

Abstract

Sebaceous carcinoma (SC) is a potentially aggressive malignancy of periocular or extraocular skin. It arises sporadically or is associated with Muir–Torre syndrome (MTS). Here, we review three controversial clinical conundra related to the diagnosis and treatment of SC and offer evidence-based recommendations. First, following a diagnosis of SC, deciding which patients to screen for MTS can be challenging. The Mayo MTS Risk Score is a clinical score that incorporates the key cutaneous findings in MTS but relies heavily on personal and family history that may not be available at the time of SC diagnosis, especially in young patients. Young patients, who have extraocular SC and are suspected to have MTS though do not meet criteria by Mayo MTS Risk Score, should have their tumors tested using immunohistochemistry for mismatch repair proteins. Second, sentinel lymph node biopsy (SLNB) is used in periocular SC to evaluate nodal disease. Patient selection is critical for SLNB. Periocular SC stage ≥ T2c (by American Joint Commission on Cancer, 8th edition) may be considered for SLNB given positivity rates over fifteen percent in expert hands. Lastly, treatment of metastatic SC is an area of active investigation. When possible, tumor profiling may be used to select targeted agents. Future research into these three key questions is needed.

Original languageEnglish (US)
Pages (from-to)25-31
Number of pages7
JournalArchives of Dermatological Research
Volume312
Issue number1
DOIs
StatePublished - Jan 1 2020

Fingerprint

Carcinoma
Sentinel Lymph Node Biopsy
Neoplasms
Skin
DNA Mismatch Repair
Patient Selection
Hand
Joints
Therapeutics
Proteins

Keywords

  • Cutaneous oncology
  • Lynch syndrome
  • Management
  • Muir–Torre syndrome
  • Sebaceous carcinoma
  • Treatment

ASJC Scopus subject areas

  • Dermatology

Cite this

Kibbi, Nour ; Worley, Brandon ; Owen, Joshua L. ; Kelm, Ryan C. ; Bichakjian, Christopher K. ; Chandra, Sunandana ; Demirci, Hakan ; Kim, John Yah Sung ; Nehal, Kishwer S. ; Thomas, James Regan ; Samuelson, Emily Poon ; Alam, Murad. / Sebaceous carcinoma : controversies and their evidence for clinical practice. In: Archives of Dermatological Research. 2020 ; Vol. 312, No. 1. pp. 25-31.
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abstract = "Sebaceous carcinoma (SC) is a potentially aggressive malignancy of periocular or extraocular skin. It arises sporadically or is associated with Muir–Torre syndrome (MTS). Here, we review three controversial clinical conundra related to the diagnosis and treatment of SC and offer evidence-based recommendations. First, following a diagnosis of SC, deciding which patients to screen for MTS can be challenging. The Mayo MTS Risk Score is a clinical score that incorporates the key cutaneous findings in MTS but relies heavily on personal and family history that may not be available at the time of SC diagnosis, especially in young patients. Young patients, who have extraocular SC and are suspected to have MTS though do not meet criteria by Mayo MTS Risk Score, should have their tumors tested using immunohistochemistry for mismatch repair proteins. Second, sentinel lymph node biopsy (SLNB) is used in periocular SC to evaluate nodal disease. Patient selection is critical for SLNB. Periocular SC stage ≥ T2c (by American Joint Commission on Cancer, 8th edition) may be considered for SLNB given positivity rates over fifteen percent in expert hands. Lastly, treatment of metastatic SC is an area of active investigation. When possible, tumor profiling may be used to select targeted agents. Future research into these three key questions is needed.",
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Sebaceous carcinoma : controversies and their evidence for clinical practice. / Kibbi, Nour; Worley, Brandon; Owen, Joshua L.; Kelm, Ryan C.; Bichakjian, Christopher K.; Chandra, Sunandana; Demirci, Hakan; Kim, John Yah Sung; Nehal, Kishwer S.; Thomas, James Regan; Samuelson, Emily Poon; Alam, Murad.

In: Archives of Dermatological Research, Vol. 312, No. 1, 01.01.2020, p. 25-31.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Sebaceous carcinoma

T2 - controversies and their evidence for clinical practice

AU - Kibbi, Nour

AU - Worley, Brandon

AU - Owen, Joshua L.

AU - Kelm, Ryan C.

AU - Bichakjian, Christopher K.

AU - Chandra, Sunandana

AU - Demirci, Hakan

AU - Kim, John Yah Sung

AU - Nehal, Kishwer S.

AU - Thomas, James Regan

AU - Samuelson, Emily Poon

AU - Alam, Murad

PY - 2020/1/1

Y1 - 2020/1/1

N2 - Sebaceous carcinoma (SC) is a potentially aggressive malignancy of periocular or extraocular skin. It arises sporadically or is associated with Muir–Torre syndrome (MTS). Here, we review three controversial clinical conundra related to the diagnosis and treatment of SC and offer evidence-based recommendations. First, following a diagnosis of SC, deciding which patients to screen for MTS can be challenging. The Mayo MTS Risk Score is a clinical score that incorporates the key cutaneous findings in MTS but relies heavily on personal and family history that may not be available at the time of SC diagnosis, especially in young patients. Young patients, who have extraocular SC and are suspected to have MTS though do not meet criteria by Mayo MTS Risk Score, should have their tumors tested using immunohistochemistry for mismatch repair proteins. Second, sentinel lymph node biopsy (SLNB) is used in periocular SC to evaluate nodal disease. Patient selection is critical for SLNB. Periocular SC stage ≥ T2c (by American Joint Commission on Cancer, 8th edition) may be considered for SLNB given positivity rates over fifteen percent in expert hands. Lastly, treatment of metastatic SC is an area of active investigation. When possible, tumor profiling may be used to select targeted agents. Future research into these three key questions is needed.

AB - Sebaceous carcinoma (SC) is a potentially aggressive malignancy of periocular or extraocular skin. It arises sporadically or is associated with Muir–Torre syndrome (MTS). Here, we review three controversial clinical conundra related to the diagnosis and treatment of SC and offer evidence-based recommendations. First, following a diagnosis of SC, deciding which patients to screen for MTS can be challenging. The Mayo MTS Risk Score is a clinical score that incorporates the key cutaneous findings in MTS but relies heavily on personal and family history that may not be available at the time of SC diagnosis, especially in young patients. Young patients, who have extraocular SC and are suspected to have MTS though do not meet criteria by Mayo MTS Risk Score, should have their tumors tested using immunohistochemistry for mismatch repair proteins. Second, sentinel lymph node biopsy (SLNB) is used in periocular SC to evaluate nodal disease. Patient selection is critical for SLNB. Periocular SC stage ≥ T2c (by American Joint Commission on Cancer, 8th edition) may be considered for SLNB given positivity rates over fifteen percent in expert hands. Lastly, treatment of metastatic SC is an area of active investigation. When possible, tumor profiling may be used to select targeted agents. Future research into these three key questions is needed.

KW - Cutaneous oncology

KW - Lynch syndrome

KW - Management

KW - Muir–Torre syndrome

KW - Sebaceous carcinoma

KW - Treatment

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U2 - 10.1007/s00403-019-01971-4

DO - 10.1007/s00403-019-01971-4

M3 - Review article

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JO - Archives of Dermatological Research

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