Case Number : Case 1537 - 16 May Posted By: Guest

Sebaceous carcinoma in-situ.

Yes Sebaceous Carcinoma, i don't know if that is at least initially invasive. 

Sebaceous lesions are always hard I agree with sebaceous carcinoma, rather low grade for my eyes. Still I would perform some extra immunos (p53, bcl-2) to unveil a bit more the biological nature of the neoplasm. Do you have experience using these markers on difficult sebaceous lesions Dr. Hurt? and a last question, is it necrosis the eosinophilic amorphous material seen in the third image? 

Going by the site and morphology, would think about a sebaceous carcinoma, provided other lesions with sebaceous differentiation are excluded with an IHC panel.

https://www.ncbi.nlm.nih.gov/pubmed/17122489  Personally I did not start using them in these lesions (yet). But I would like to try them eventually. Nevertheless, p53 and bcl-2 are sometimes hard to interpret and in the best of chances they are only useful for supporting the diagnosis. I think it is also true that in the case of p53 the assesment is somewhat confusing in general practice, strangely in the article they dont seem to consider a null cell pattern seen in some of the benign cases as indicative of mutation of P53...