Sebaceous carcinoma of the lip.

Sebaceous carcinoma (SC) is an uncommon neoplasm. To date fewer than 400 cases have been reported in literature. Due to the low incidence and the not universally accepted histopathological classification, it presents diagnostic problems1. Generally, the lesions arise in the meibomian glands of the eyelid. However, extra-ocular localisation in the head and neck region have been reported. While several reports have documented sebaceous adenomas arising from sebaceous glands of the oral cavity, oral sebaceous carcinomas are extremely rare. To date only six cases have been described2. The salivary glands too are considered an uncommon site, even if some cases arising in the parotid gland were recognised. Herein we reported a case of SC arising in the lateral edge of the lower lip in a 71-year-old men. To the best of our knowledge this is the second case described in lips. The clinical differential diagnosis included squamous cell carcinoma, basal cell carcinoma with sebaceous differentiation (BCCSD) and salivary gland neoplasms. The operation was performed under local anaesthesia. The lesion was removed with 0.5 cm of free margins and a W shaped wedge. The defect was primarily closed. The post-operative course was uneventful. Although SC may be found among the multiple sebaceous neoplasms occurring in association with multiple visceral carcinomas in the Muir-Torre syndrome, in the present case the lip was the only localisation of SC. SC must be distinguished from basal cell carcinoma with sebaceous differentiation (BCCSD). The diagnosis may be facilitated by lipophylic stains on frozen sections or immunostains for EMA and S-100.