FNA diagnosis of recurrent sebaceous carcinoma

We describe fine-needle aspiration (FNA) diagnosis in a case of sebaceous carcinoma presenting as recurrent swelling eyelid. The patient, a 35-yr-old woman, presented with a gradually increasing painless mass in the left upper eyelid. She had a history of excisions of swelling at the same site over a period of 5 years. On FNA, the smears were cellular and demonstrated sheets, three dimensional clusters, and singly scattered polygonal tumor cells having centrally located hyperchromatic and pleomorphic nuclei and cytoplasmic microvacuolations. Oil red-O stain performed on air-dried smears showed positivity, confirming the presence of intracellular and extracellular lipid globules. A final impression of sebaceous carcinoma of the left upper eyelid was rendered, based on which the eyelid mass was radically excised. Subsequent histopathology confirmed the diagnosis. Despite wide excision, such tumors not uncommonly recur and metastasize. An early and accurate diagnosis of such lesions can be established on minimally invasive needle aspiration.