Extraocular Sebaceous Carcinoma of the Scalp in an Elderly Patient

Sebaceous carcinoma (SC) is a rare and aggressive malignant neoplasm of the sebaceous glands, most commonly arising in the periocular region. Extraocular SC, particularly when located on the scalp, is a rare condition that is often misdiagnosed, resulting in delays in treatment. An 85-year-old woman presented to the outpatient clinic with a slowly enlarging scalp mass. Initial surgical excision was performed, and histopathological examination confirmed SC. The patient subsequently underwent wide local excision and comprehensive staging imaging, which revealed no residual disease or metastatic spread. She was therefore managed with close clinical follow-up. Extraocular SC is an aggressive neoplasm with a significant risk of local recurrence and metastasis, particularly when arising on the scalp, where it may be misdiagnosed as other cutaneous malignancies. Accurate diagnosis relies on histopathological evaluation supported by immunohistochemical analysis. Complete surgical excision with clear margins, including wide local excision or Mohs micrographic surgery, remains the cornerstone of treatment. Early recognition and timely intervention are critical determinants of prognosis. SC of the scalp is a rare but potentially life-threatening malignancy. Inclusion of this entity in the differential diagnosis of atypical scalp lesions in elderly patients, along with prompt biopsy and appropriate surgical management, is essential to optimize clinical outcomes.