Abstract
Sebaceomas are benign adnexal tumors arising from the sebaceous gland. Clinically, they present as solitary yellow or orange papules or nodules on the face or scalp. Histologically, sebaceomas are characterized by lobules of basaloid cells sparsely populated with sebocytes and foci of ductal differentiation. Herein we report a case of a 67-year-old white man presenting with a 6 mm pink and yellow pearly papule on his forehead that was asymptomatic and slow growing. A shave biopsy of the lesion revealed a lobular endophytic basaloid epithelial neoplasm arising from the epidermis encased in a circumscribed fibromyxoid stroma. Within the tumor were scattered sebocytes and small ducts, highlighted with adipophilin and CEA, respectively. Small islands and anastomosing strands of tumor were embedded in a sclerotic stroma adjacent to the lobular tumor. Portions of the tumor were EMA positive. Significant atypia and mitotic activity were not identified. Sebaceoma variants are typically classified by their epithelial component, which includes rippled-patterned, reticulated, cribriform, and verruca/seborrheic keratosis subtypes. While it is common to see stromal desmoplasia in certain adnexal neoplasms such as desmoplastic trichoepithelioma, desmoplastic trichilemmoma, and trichoblastic fibroma, sclerotic changes occurring in a sebaceoma have rarely been reported.
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