[The development of malignant tumors in nevus sebaceus--therapeutic consequences]

Nevus sebaceus has been considered a relatively infrequent and unimportant congenital hamartoma for plastic surgeons, unless the lesions are so big that they require a large closure of the defect. As such tumors are primarily of a benign nature and the malformed sebaceus glands are located abnormally high in the dermis, surgeons are tempted not to excise the tumors but to eradicate them by dermabrasion or laser beam therapy. Yet, a nevus sebaceus does not only affect sebaceus glands but includes various other malformations of the affected skin and its appendages. In addition, different malignant tumors may occur in nevus sebaceus, even in children and young adults.

We encountered 4 such malignant tumors out of 18 nevus sebaceus operated from 1989 to 1997. All nevi had been clinically inconspicuous.

In three patients, one of them being only fifteen years old, an associated basal cell carcinoma was found. The fourth patient had a mixture of three additional tumours, a cystadenoma, a keratoacanthoma and a basal cell carcinoma besides the sebaceous malformations.

These findings have two consequences. The first is to continue surgical treatment of nevus sebaceus instead of dermabrasion or dermablation and to have the specimen examined histologically. The second consequence is to excise such tumors as early as possible.