Aggressive sebaceous carcinoma of the head

Cutaneous sebaceous carcinoma (SC) is a rare malignancy deriving from the adnexal epithelium of the sebaceous glands. Periorbital SC is approximately three times more common than extraorbital cutaneous SC. Extraocular SC is reported to be less aggressive than orbital sebaceous carcinoma and rarely metastasizes. We report a case of sebaceous carcinoma of the scalp, characterised by highly aggressive behaviour and huge invasion of the intracranial space. The patient was a 79-year-old woman who developed an infiltrating sebaceous carcinoma followed by lymph-node metastases shortly after excision of the primary lesion, resulting in death. In this case, aggressive biological behaviour was observed in a carcinoma arising in an extraorbital area, although it has traditionally been considered a less aggressive neoplasm.