Mayoclinic
Sebaceous gland cancer or sebaceous gland carcinoma is a rare and aggressive type of skin cancer. It is a fast-growing cancer that metastasises in a large number of patients and often recurs after treatment. The tumours grow from epithelial cells within the sebaceous glands, which can be found in the skin and around the eye.
Sebaceous gland cancer is most often found in the epithelial cells of the sebaceous glands of the skin and the eyelids. Although the upper eyelid is the most common place for this cancer to develop, sebaceous gland cancer can occur anywhere in the body where there are sebaceous glands. If the tumour spreads from the eyelid, it usually goes to the lower eyelid or into the eye socket. Left untreated, this tumour can spread to the sinuses or the bones that make up the skull.
Sebaceous glands produce sebum, an oily substance that keeps the skin from dehydrating and makes it water-resistant. The sebaceous glands in the eyelids ensure that the eyes remain moist and keep the eyelashes free from dead cells, micro-organisms and dirt.
This is a rare cancer that is mostly diagnosed in men and women over the age of 60.
A sebaceous gland tumour often appears as a yellowish lump on the eyelid, which usually causes no pain, although redness and swelling can appear around the eyelid. Spots like these occur frequently around the eye and are almost always benign. When they don’t disappear after six weeks and grow in size, patients are advised to see their GP.
A clear cause for sebaceous gland cancer has never been identified, but there are certain known risk factors. Some patients suffer from the Muir-Torre syndrome, which is related to Lynch syndrome, that causes an elevated risk for several cancer types. People with Muir-Torre syndrome are also prone to benign growths in the sebaceous glands. Some patients with this syndrome have a mutation in the MSH2 gene, which stops damaged DNA from being repaired. Other patients have a mutation in the MLH1 or MSH6 gene.
Since sebaceous gland cancer of the eyelid looks very similar to other, less rare afflictions, the disease is not easy to diagnose. In some cases, the disease is diagnosed as a different type of cancer. Because of this, valuable time is lost in starting the proper treatment for this cancer.
Often, a GP will refer a patient to a dermatologist, ophthalmologist or plastic surgeon. They will very likely perform a biopsy and have a tissue sample sent to a lab for microscopic research. Often, the cancer is diagnosed in this manner. Ultrasounds, MRI scans, CT scans, lung X-rays and FDG-PET-CT scans can then be applied to establish whether the cancer has spread.
Once sebaceous gland cancer has been diagnosed, specialists will come up with a treatment strategy. Depending on location and advancement of the cancer, treatment options include surgery, radiotherapy and chemotherapy, with surgery being the preferred treatment.
If the cancer has spread, as is often the case, only palliative care remains available, with chemotherapy as primary treatment. In a refractory or locally advanced setting, targeted therapy may offer an efficacious alternative, with research currently ongoing into this therapeutic area.
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