Sebaceous carcinoma in solid organ transplant recipients.
BACKGROUND
Though a rare tumor, sebaceous carcinoma is relatively well-described in immunocompetent patients, in whom it often occurs in a periorbital distribution where it has an overall poor prognosis with a high metastasis rate. The effect of transplant-related immunosuppression on the development of sebaceous carcinoma and its outcomes has not been characterized.


METHODS
We collected 9 cases from a single institution of patients developing sebaceous carcinoma after solid organ transplantation. We analyzed clinicopathologic features.


RESULTS
We estimate the prevalence of sebaceous carcinoma post-solid organ transplantation to be 0.09%. The mean age at diagnosis was 66.1 years (std 7.0 years). The mean time between transplantation and sebaceous carcinoma diagnosis was 7.1 years (std 5.1 years). All tumors occurred in extra-ocular distribution. Two patients likely had Muir-Torre syndrome, of whom 1 died from metastatic sebaceous carcinoma. No other patients developed metastatic disease or had disease-related death. Mohs micrographic surgery and wide local excision were equally effective and there were no recurrences with either procedure.


CONCLUSIONS
Our study found that sebaceous carcinoma in solid organ transplant recipients occurs in in an extraorbital distribution with only 1 patient developing metastatic disease. Both Mohs micrographic surgery and wide local excision are acceptable treatment modalities for sebaceous carcinoma in transplant recipients.
Mayo Clinic Arizona, Scottsdale, AZ, USA.
Elika
E
Hoss
Mayo Clinic Arizona, Scottsdale, AZ, USA.
Steven A
SA
Nelson
Mayo Clinic Arizona, Scottsdale, AZ, USA.
Amit
A
Sharma
D000368:Aged; D002277:Carcinoma / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D004268:DNA-Binding Proteins / Q000378:metabolism; D006801:Humans; D007165:Immunosuppression Therapy; D016030:Kidney Transplantation; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D000070976:Mismatch Repair Endonuclease PMS2 / Q000378:metabolism; D055653:Muir-Torre Syndrome / Q000175:diagnosis* / Q000378:metabolism; D000070957:MutL Protein Homolog 1 / Q000378:metabolism; D051718:MutS Homolog 2 Protein / Q000378:metabolism; D012189:Retrospective Studies; D012626:Sebaceous Gland Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery
D004268:DNA-Binding Proteins; C094443:G-T mismatch-binding protein; C501486:MLH1 protein, human; C094934:PMS2 protein, human; C497172:MSH2 protein, human; D000070976:Mismatch Repair Endonuclease PMS2; D000070957:MutL Protein Homolog 1; D051718:MutS Homolog 2 Protein