Histology: These tumors are derived from sebaceous glands and show a high degree of infiltrative growth. The tumor deeply invades the subcutaneous tissue; in the periocular area, it often invades the underlying muscle tissue. The lesions are poorly circumscribed, and mitoses are frequently seen. The tumor cells are large basaloid cells that show areas of mature sebocyte differentiation and areas that are poorly differentiated.
Treatment: The tumors are locally aggressive and have a high rate of regional lymph node metastasis. The treatment of choice is surgical removal, either with Mohs micrographic surgery or with a wide local excision, making sure to get clear tumor margins. These tumors have a high risk of recurrence, and clinical follow-up is required. The use of postoperative radiotherapy is warranted in specific cases. Patients with metastatic disease may benefit from a combination of radiotherapy and systemic chemotherapy.
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