Extra-Ocular Sebaceous Carcinoma Unveiled: A Case Study of Dermal Challenges in an Elderly African American Patient

Sebaceous carcinoma is a rare malignant tumor of the sebaceous glands that most commonly presents in the periocular area. Uncommon extraocular manifestations are occasionally observed, often limited to the head or neck but can occur wherever sebaceous glands are found. There are increasing cases of sebaceous carcinoma in the United States which continue to pose ongoing diagnostic challenges. We present a patient with a 5.5 x 4 x 2 cm gradually growing necrotic and fungating upper back mass, present for one year. This lesion was initially diagnosed as an excoriated sebaceous adenoma, microscopically showing well-formed organoid structures and no irregular infiltration into the dermis, but was later confirmed as sebaceous carcinoma, demonstrating prominent mitosis and infiltrative growth pattern, following wide surgical excision. Margins were clear following the surgery with no signs of recurrence but further treatment recommendations included follow-up with oncology due to the rarity and aggressive nature of this tumor. This case serves to present an atypical presentation of a rare malignancy that has an increased occurrence rate for unknown reasons.