Sebaceous gland tumors and systemic disease: a clinicopathologic analysis

The association of sebaceous gland neoplasms with visceral carcinomas, first described by Muir and Torre, has become widely recognized. The purpose of our study was to determine the prevalence of malignancy, other associated diseases, and familial carcinoma in patients who had one or more cutaneous lesions within the spectrum of sebaceous adenoma, epithelioma, or carcinoma. Our histopathology files contained tissue from 59 such cases. Overlap between the categories was common, often precluding precise histologic classification. Of the 59 patients, 25 (42%) had one or more primary visceral malignancies. These totaled at least 49, of which 25 were colonic, 9 urogenital, 5 hematologic, 4 breast, and 6 miscellaneous. Fifteen patients (25%) had colonic polyps, most often multiple; and at least one primary carcinoma of the colon appeared in 10 of these, initially or later. Other less common findings included uterine fibroids, thyroid adenomas, and benign renal cysts. A family history of carcinoma was found in 72% of cases with visceral malignancy, most often of the colon and stomach. We conclude that sebaceous neoplasms form a histologic continuum, and strong associations with colonic polyps, internal malignancy, and a family history of carcinoma are apparent.