Cancer of the sebaceous glands of the scalp. Tumors of the sebaceous glands of dogs and cats

- a group of true neoplasias and tumor-like formations developing in the area of the sebaceous glands. They can be single or multiple, benign or malignant. Usually located in the area of the face and scalp. In most cases, they are small hemispherical painless nodules of a yellowish color. Some sebaceous gland tumors are prone to ulceration and recurrence. The diagnosis is made on the basis of anamnesis, objective examination and the results of histological examination. Treatment – electrical excision, cryodestruction, surgical excision.

General information

Tumors of the sebaceous glands are a heterogeneous group of tumors and tumor-like lesions of the sebaceous glands, mainly localized in the head area. As a rule, they proceed benignly. True tumors of the sebaceous glands are usually diagnosed in older people. Tumor-like formations can be detected both in children and young people, and in elderly patients. True benign tumors of the sebaceous glands include adenoma, and malignant tumors include adenocarcinoma. The group of tumor-like processes includes sebaceous nevus, Pringle's sebaceous adenoma and rhinophyma. Treatment is carried out by specialists in the field of oncology, dermatology and cosmetic surgery.

True tumors of the sebaceous glands

When examining patients with a tumor of the sebaceous glands, a significant enlargement of the nose is revealed. It is possible to have both a uniform change in size and the formation of tuberous nodes in the area of the wings and the tip of the nose. Tumors of the sebaceous glands can reach significant sizes, hang into the area of the nasolabial triangle, close the lips, and make breathing and eating difficult. The surface of the nodes is covered with telangiectasias and acne-like rashes, from which thick whitish contents are released when pressed. Treatment of sebaceous gland tumors is surgical. With complete excision the prognosis is favorable. In case of incomplete removal, recurrence is possible.

Text of the article and photos from the book
SMALL ANIMAL DERMATOLOGY
A COLOR ATLAS AND THERAPEUTIC GUIDE
KEITH A. HNILICA, DVM, MS, DACVD, MBA 2011

Translation from English veterinarian Vasiliev AB

Peculiarities

Nodular sebaceous hyperplasia, sebaceous epithelioma, and sebaceous adenoma are benign tumors of the secretory cells of the sebaceous glands. They are common in older dogs, with the highest incidence in poodles, cocker spaniels, miniature schnauzers and terriers (sebaceous adenoma/hyperplasia) and in Shih Tzus, Lhasa Apso, Siberian Huskies and Irish Terriers (sebaceous epithelioma). Benign sebaceous gland tumors are uncommon in older cats, with a possible predisposition in Persian cats. Sebaceous adenocarcinomas are rare malignant tumors of older dogs and cats. Among dogs, cocker spaniels are predisposed.

Benign tumors of the sebaceous glands of dogs and cats are usually solitary, hard, raised, cauliflower-like or warty in appearance and vary from a few millimeters to several centimeters in diameter. The lesions may be yellowish or pigmented, lack hair, have a greasy appearance, or be ulcerated. Nodules with hyperplasia of the sebaceous glands can be multiple. Sebaceous adenocarcinomas tend to appear as solitary, hairless, ulcerated or erythematous intradermal nodules, less than 4 cm in diameter, that invade the subcutaneous tissue. Tumors of the sebaceous glands of dogs and cats occur most often on the trunk, paws, head and eyelids in dogs and on the head in cats.

Diagnosis

1 Distinct growth in the form of warts or cauliflower

2 Cytology:

Hyperplasia/adenoma of the sebaceous glands: The cells slough off in groups and look similar to normal sebaceous gland cells with foamy pale blue cytoplasm and small dark nucleoli.

Epithelioma of the sebaceous glands: small, uniform, sometimes melanotic epithelial cells with a small number of sebaceous gland cells.

Sebaceous gland carcinoma: extremely basophilic basophilic cell type with nuclear and cellular pleiomorphism.

3 Dermatohistopathology:

Hyperplasia of the sebaceous glands: multiple enlarged mature lobules of sebaceous glands with one peripheral layer of basaloid germ cells and a central duct. No mitotic figures are observed.

Sebaceous gland adenoma: Similar to hyperplasia, but with increased numbers of basaloid germ cells and immature sebaceous gland cells. Low mitotic activity and loss of organization are visualized around the central duct.

Epithelioma of the sebaceous glands: Multiple lobules of basaloid epithelial cells interspersed with reactive collagenous tissue and secondary inflammation. Early high mitotic activity is observed. Scattered areas of sebaceous gland cell differentiation, squamous metaplasia, or melanization may be observed.

Adenocarcinoma of the sebaceous glands: poorly defined lobules of large epithelial cells with varying degrees of differentiation and cytoplasmic vacuolization. The nucleoli are large and mitotic activity is moderately high.

Treatment and prognosis

1 For benign tumors of the sebaceous glands of dogs and cats, observation without treatment is advisable

2 Surgical removal (laser ablation or cryosurgery) of benign sebaceous tumors is usually indicated and sufficient for cosmetically unacceptable tumors or tumors

Which disturbs the animal.

4 The prognosis is good. Benign tumors of the sebaceous glands of dogs and cats do not invade locally, do not metastasize, and rarely recur after surgical removal. Sebaceous adenocarcinomas locally infiltrate surrounding tissues and sometimes involve regional lymph nodes, but distant metastasis is rare.

Photo 1 Tumors of the sebaceous glands of dogs and cats. This sebaceous adenoma on the nose exhibits a characteristic "cauliflower" appearance.

Photo 2 Tumors of the sebaceous glands of dogs and cats. This sebaceous gland adenoma persisted for several years with little progression.

Photo 3 Tumors of the sebaceous glands of dogs and cats. This adenoma of the sebaceous glands on the pinna demonstrates the characteristic size and shape of these tumors.

Most often, adenoma affects the skin of the face, causing a lot of unpleasant sensations of a physical and psychological nature.

Pathology is not a malignant disease, but still requires diagnosis and treatment. In exceptional cases, it is possible to identify a disease that predisposes to cancer.

Sebaceous glands are necessary to protect the human surface from bacteria by secreting sebum. They are located between hair follicles and muscle fibers. The glands consist of a sac and a duct. They are located near the upper layer of the epidermis. Nutrients enter them from many blood vessels.

Sebaceous glands are located throughout the human body, except for the feet and palms. Excessive sebum production leads to clogged pores, which leads to the development of skin diseases. A large number of glands are located on the face.

Adenomas can appear in childhood, gradually growing in the area of the nose, chin, ears, nasolabial folds, and scalp. Less common are adenomas on the body, neck, and limbs. They consist of mature particles of sebaceous glands and growth elements.

Causes

The exact reasons for the appearance of sebaceous gland formations are unknown. Scientists continue to study this issue.

Probable reasons:

Heredity– pathology manifests itself when there is at least one “defective” gene in the body. It can be received from one of the parents and provoke the formation of new benign formations.
Rebirth– tissues change against the background of the nevus. Most often localized on the scalp and face.
Chronic diseases– adenomas on the nose are often associated with inflammatory bowel diseases such as colitis and gastritis. This pathology is called rhinophyma.

There are also predisposing factors. They are associated with the prolonged presence of rosacea and adverse effects of the external environment in the form of temperature changes and severe hypothermia.

Risk group

Benign formations of the sebaceous glands affect people of different ages and genders. Everyone is at risk:

Children– Pringle-Bourneville pathology is often detected in young patients. It begins in the form of spots, and thickenings on the skin are yellow in color. They can most often be found on the lower back.
Men over 40 years old– Among this group of patients, rhinophyma is more often diagnosed. It is characterized by the proliferation of glands on the nose. It increases in size and has a bumpy surface with rashes.
Elderly people– the disease often manifests itself in adulthood. This may be due to its slow development and the absence of a painful syndrome. At a young age, the formations are simply invisible.

Any person can develop pathology, regardless of social status. The disease occurs in 1 patient per 100,000 inhabitants of the planet. This indicator classifies the disease as an extremely rare species.

There are no special preventive measures to prevent the development of skin adenomas. Doctors recommend regularly undergoing a complete medical examination of the body. This will allow the formation to be identified in a timely manner.

Kinds

Experts distinguish three types of sebaceous gland adenoma. Each of them has its own distinctive features:

Pringle-Bourneville– the neoplasm looks like a nodule 1-10 mm in diameter, round in shape. Its color varies from light yellow to deep brown. Regardless of the number of nodules, they do not merge together. The disease is considered hereditary.
Allopo-Leredda-Dariye– the pathology is called symmetrical, it has the color of the skin, a close consistency, and forms symmetrically on the face. Fibromous areas, cylindromas, and birthmarks are associated with this formation.
Balzera-Menetrier– the neoplasm has a white or yellow tint. It has the shape of a nodule of dense consistency with a smooth surface. Sometimes nodules can hang down on a stalk, forming in the area of the face, neck, and in the oral cavity. The disease is called cystic epithelioma.

Some types of sebaceous gland adenomas are accompanied by epilepsy, as well as mental retardation. Although this is not the rule.

Complications

Adenomas are benign tumor-like lesions of the sebaceous glands. But that doesn't mean they can't cause problems. Timely removal of the pathology will avoid consequences.

Complications and consequences during a long course of the disease:

Conjunctivitis– the mucous membrane of the eye becomes inflamed.
Blepharitis– the ciliary edge of the eyelid becomes inflamed.
Keratitis– the cornea of the eye becomes inflamed, causing it to become cloudy and reduce visual acuity.
Psychoneurological disorders– pathology can grow in the area of the cerebral ventricles.
Cysts– in patients with adenoma of the sebaceous glands, cysts of internal organs appear. They are most often detected in the lungs, kidneys, and heart.
Difficulty breathing– with rhinophyma, an enlarged nose can cover the upper lip. Because of this, it is difficult for the patient not only to breathe, but also to eat.

The treatment prognosis is favorable. But before this, you need to make sure that we are talking about a true adenoma, and not about an oncological process.

Cancer

It is extremely rare that cancer can be hidden under an adenoma of the sebaceous glands. It is more often detected in older people. The reasons for its development are unknown. In appearance, the malignant formation resembles a nodule that is prone to ulceration.

The tumor consists of lobules that differ in size and shape. Closer to its center, the lobules are larger than those at the edges. Malignant tumors are characterized by an aggressive course; metastases spread by lymphogenous and hematogenous routes. The presence of secondary lesions makes the prognosis unfavorable. Adjacent lymph nodes are the first to be affected.

Symptoms

A common symptom of sebaceous gland pathology is the presence of a nodular neoplasm. More often its size does not exceed 5-10 mm. It has a round shape and is white, pink, yellow, brown. As a rule, the skin is affected by many such nodules.

Other manifestations:

Slow growth– the neoplasm grows and develops over many years, it does not manifest itself in any way.
Inflammatory process– in rare cases, the adenoma can become painful, and the skin becomes pink and unhealthy.
Swelling– over time, a swelling appears at the site of the nodule, which grows and does not stop. When you press it outward, the contents of the adenoma may appear.
Dark spots– the shape of the spots resembles a leaf; they are found in large numbers in the lumbar region. They have a yellowish color, although sometimes they practically do not differ from the shade of ordinary skin.
Mental retardation– the hereditary form of adenoma in 60% of cases is accompanied by developmental problems. All types of memory are impaired. Sick children may experience paralysis and hydrocephalus.

When a tumor develops on the head under the hair, it is difficult to detect. For many years it develops unnoticed.

Diagnostics

An external examination by a specialist may be sufficient to make a diagnosis. The dermatologist will clarify the information about the time of the appearance of the formation, examine it visually, and palpate the skin around it. If an oncological process is suspected, the doctor will prescribe additional tests:

Histology– the skin is collected from the affected area of skin by scraping it. Biological material is examined under a microscope for the presence of cancer particles.
Genetic consultation– one of the causes of the pathology is considered to be a genetic mutation. To minimize the risk of relapse, it is necessary to consult a geneticist who can determine the cause of the disease.

It may also be necessary to consult a neurologist, ophthalmologist, surgeon, or oncologist. This depends on the location of the formation and the severity of its occurrence.

Treatment

Treatment of adenoma on the skin is carried out by removing it. In the initial stages, the procedure can be performed by a dermatologist. Removal is done in various ways:

Cryodestruction– pathology is destroyed using liquid nitrogen. Due to exposure to low temperature, blood circulation in the tumor stops. This leads to the death of its cells. The procedure can be performed with pain relief. The defect is rejected within 2-6 weeks.
Electrocoagulation– hair electrodes are used for the procedure. The technique involves cauterizing the affected areas with electric current. As a result of the manipulation, the neoplasm is excised, and the resulting wound heals over time.
Laser– the procedure is performed under local anesthesia using a high-energy carbon dioxide laser. A wound remains at the site of the tumor. A crust will form on it, which should not be touched. The method has a good cosmetic effect, which is important when removing adenomas in the facial area.
Treatment of the source disease– some neoplasms are associated with problems in the digestive system. Without eliminating them, removal of a benign formation can lead to relapse.

Complications may develop during treatment. They are associated with violations of the technique of the procedure and the rules for caring for the formed wound. Therefore, it is very important to select a highly qualified specialist to carry out the procedure and adhere to the recommendations received.

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Sebaceous gland carcinoma is an aggressive but rare type of skin cancer. It usually affects the eyelid area, but can develop anywhere else, since sebaceous glands are present throughout the body. This type of cancer is often mistaken for other, less serious illnesses.

Carcinoma is a malignant neoplasm that forms from epithelial cells. Due to malignancy, it can spread to surrounding tissues, and in later stages - through the lymphatic or circulatory system - to other organs and parts of the body.

Sebaceous glands are found in the dermis, or middle layer of the skin. They secrete sebum, an oily substance that softens the skin and hair. These glands can easily become clogged with dried sebum, dirt or bacteria, which in turn can lead to the formation of hard nodules on the surface of the skin that are often painless but noticeable. Sebaceous gland carcinoma also causes similar, hard, painless nodules to form on the skin, but these nodules are actually cancerous tumors.

The most common place for the formation of such tumors is the inner surface of the eyelid, since many sebaceous glands are located in this area.

Also, sebaceous gland carcinomas are usually characterized by convexity and extreme vascularity, i.e. the presence of many blood vessels. Correct diagnosis of this disease may require a biopsy. As the tumor grows in size, it may become pigmented, usually taking on a yellowish tint. This staining occurs due to the attachment of lipids to the tumor as it extends beyond the dermis into the epidermis. The tissue around the tumor usually becomes red and inflamed.

How is sebaceous gland carcinoma treated?

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Sebaceous gland carcinoma can be removed through surgery, but it may also require more aggressive cancer treatments. Radiation therapy or chemotherapy is usually recommended for patients, especially in the later stages of the disease. Sebaceous gland carcinoma has a very high mortality rate due to the high likelihood of metastasis.

This type of cancer is most common among older people, as well as younger people with other eye abnormalities such as retinoblastoma. Moreover, women are more susceptible to its development. It is a much rarer disease than its similar basal cell carcinoma.

Sebaceous gland carcinoma may also be a feature of Muir-Torr syndrome. Patients with this syndrome have several malignant skin tumors in various locations throughout the body, including the sebaceous glands. The most common areas of the body where additional tumors develop in Muir-Torr syndrome include the colon and kidneys. Therefore, if sebaceous gland carcinoma is detected, patients should be screened for other malignancies and seen by a physician to ensure that Muir-Torr syndrome is not present.

Atheromas are usually called tumor-like formations that arise due to blockage of the sebaceous gland, although this class of tumors also includes other skin cysts of different etiologies. It is extremely rare, but skin atheroma can transform into a malignant tumor, so its timely diagnosis and treatment are very important for the patient’s health. In addition, skin atheromas can be quite painful and carry a risk of infection, and therefore require careful attention from a dermatologist.

Skin atheroma gets its name from the Greek words meaning “tumor” and “gruel”, since it is a rounded formation in the form of a capsule filled with a thick yellowish or white mass with an unpleasant odor. This mass is a protein called keratin, which is produced by the walls of the capsule. Skin atheroma is more common in middle-aged women, although it can also affect men. The reasons for its development have not yet been identified, although some scientists are inclined to the idea of a hereditary predisposition.

Skin atheroma is considered a tumor-like formation, an epithelial cyst, which is formed as a result of blockage of the sebaceous gland - its excretory duct. Depending on the histological structure, these can be retention, epidermal, trichylemmyal cysts, multiple steatocystomas, but in their clinical manifestations they are practically the same, and therefore they are all called skin atheromas.

Main symptoms of skin atheroma and possible complications

Most often, skin atheroma occurs on the scalp, face, back and neck, in the groin area - where there are a large number of sebaceous glands. Blockage of the sebaceous gland is rarely a single formation; usually there are multiple skin atheromas - there can be more than ten of them in one patient.

When visiting a doctor, patients complain of a tumor that has appeared under the skin, which can move under the finger and has a dense structure. The skin over the atheroma, as a rule, is not changed, but in case of inflammation it turns red, and if the formation grows rapidly, it becomes ulcerated, and the point where the sebaceous gland is blocked appears in the center.

Skin atheroma can remain small throughout life or begin to increase in size, be located under the skin or have an excretory duct on its surface.

Complications of the disease can occur when the focus of skin atheroma is injured, as well as when immunity is reduced, personal hygiene is not observed, and in patients with diabetes. In this case, atheroma suppurates, the skin turns red, swells, the inflammation site hurts and increases in size. If therapeutic measures are not taken on time, purulent inflammation can spread to surrounding tissues, and then the formation of abscesses and the development of phlegmon are likely. The festering cyst ruptures into the subcutaneous tissue. Such complications of sebaceous gland blockage often leave rough scars after treatment. In addition, with severe suppuration of the lesion, it is not always possible to completely remove the skin atheroma capsule, and this can further provoke relapses of the disease.

In order to prevent severe complications of skin atheroma, all inflamed elements need to be sanitized surgically - the abscesses are opened and drained. Sometimes, in order to cope with the consequences of inflammation, a course of antibiotics is prescribed.

Treatment of skin atheroma and features of postoperative rehabilitation

It is possible to treat skin atheroma only surgically, since the only way to get rid of a blockage of the sebaceous gland is to remove the entire tumor along with the capsule in which it is enclosed.

When removing skin atheroma, local anesthesia is performed, then an incision is made over the tumor, approximately 3-4 mm in size, through which either the entire tumor is removed without opening, or its contents are first removed and then the capsule itself (in this case, a minimal incision is needed). The incision is made along the lines of force and is closed with a cosmetic suture or plaster. Methods for removing skin atheroma using biopsy instruments are described - a round section of skin with a diameter of about 5 mm is removed above the atheroma and the capsule is removed, and then the wound is sutured.

Removal can be carried out either with a scalpel or using a radio wave knife or laser beam. In the case of radio wave and laser exposure, removal of skin atheroma occurs with little trauma, without bleeding (since the vessels are immediately sealed) and with a minimal risk of wound infection).

The result of the operation depends on whether the capsule is completely removed, whether the surgical technique is followed, whether the wound is closed correctly, as well as on the characteristics of the patient’s skin and his compliance with postoperative recommendations not to wet the wound for two days, treat it daily with an antiseptic, and protect it from injury.