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 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, physical examination and histological examination results. Treatment - electroexcision, cryodestruction, surgical excision.

General information

Tumors of the sebaceous glands are a heterogeneous group of tumors and tumor-like lesions of the sebaceous glands, predominantly 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, malignant - adenocarcinoma. The group of tumor-like processes includes nevus sebaceous glands, adenomas of Pringle's sebaceous glands and rhinophyma. The 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 increase in the nose is revealed. Both a uniform change in size and the formation of tuberous nodes in the region of the wings and the tip of the nose are possible. Tumors of the sebaceous glands can reach a significant size, hang down in the region of the nasolabial triangle, close the lips, make it difficult to breathe and eat. The surface of the nodes is covered with telangiectasias and acne-like rashes, from which, when pressed, a thick whitish content is released. Surgical treatment of tumors of the sebaceous glands. With complete excision, the prognosis is favorable. With incomplete removal, recurrence is possible.

Text of the article and photo 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 Tzu, Lhasa Apso, Siberian Huskies and Irish Terriers (sebaceous epithelioma). Benign sebaceous 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 sebaceous tumors in dogs and cats are usually solitary, firm, raised, cauliflower or warty in appearance, and vary from a few millimeters to several centimeters in diameter. Lesions may be yellowish or pigmented, hairless, greasy, or 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 frequently 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: Cells slough off in clusters and look similar to normal sebaceous gland cells with foamy pale blue cytoplasm and small dark nucleoli.

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

sebaceous gland carcinoma: Extremely basophilic basal-type cells with nuclear and cellular pleiomorphism.

3 Dermatohistopathology:

Hyperplasia of the sebaceous glands: multiple enlarged mature sebaceous gland lobules with one peripheral layer of basalioid germ cells and a central duct. Mitotic figures are not observed.

Adenoma of the sebaceous glands: similar to hyperplasia, but with increased numbers of basalioid germ cells and immature sebaceous cells. Around the central duct, low mitotic activity and loss of organization are visualized.

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

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 reasonable.

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

that disturb 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 occasionally involve regional lymph nodes, but distant metastasis is rare.

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

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

Photo 3 Tumors of the sebaceous glands of dogs and cats. This auricular sebaceous adenoma shows 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 does not apply to malignant diseases, but still requires diagnosis and treatment. In exceptional cases, it is possible to identify a disease that predisposes to oncology.

The sebaceous glands are necessary to protect the human surface from bacteria, releasing sebum for this. They are located between the hair follicles and muscle fibers. The glands consist of a sac and a duct. They are located near the top layer of the epidermis. Nutrients come to them from many blood vessels.

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

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

The reasons

The exact causes of the appearance of formations of the sebaceous glands are unknown. Scientists continue to study this issue.

Likely causes:

Heredity- pathology manifests itself in the presence of at least one "defective" gene in the body. It can be obtained from one of the parents and provoke the formation of new benign formations.
rebirth- tissues change against the background of a nevus. More often localized on the scalp and face.
chronic diseases Nasal adenomas are often associated with inflammatory bowel disease such as colitis and gastritis. Such a pathology is called rhinophyma.

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

Risk group

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

Children- Often in young patients, Pringle-Bourneville pathology is detected. It originates in the form of spots, there are also thickenings on the skin of yellow color. They are most often found on the lower back.
Men over 40- Among this group of patients, rhinophyma is more often diagnosed. It is characterized by the growth of glands on the nose. It increases in size, has a bumpy surface with rashes.
elderly people- the disease often manifests itself in adulthood. Perhaps this is 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 extremely rare.

There are no special preventive measures to prevent the development of adenomas of the skin. Doctors recommend regularly undergoing a complete medical examination of the body. It will allow timely detection of the formation.

Kinds

Experts distinguish three types of adenomas of the sebaceous glands. Each of them has its own distinctive features:

Pringle-Bourneville- the neoplasm looks like a nodule 1-10 mm in diameter, rounded. 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 Darya- the pathology is called symmetrical, it has the color of the skin, a tight texture, it is formed symmetrically on the face. Fibromous areas, cylindromas, birthmarks are associated with this formation.
Balzer-Menetrie- the neoplasm is distinguished by a white or yellow tint. It has the form of a nodule of dense consistency with a smooth surface. Sometimes the nodules can hang down on the leg, forming in the area of the face, neck, and in the oral cavity. The disease is called cystic epithelioma.

Some types of adenomas of the sebaceous glands 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 pathology will avoid consequences.

Complications and consequences in the 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 becomes inflamed, causing it to become cloudy and reduce visual acuity.
Psychoneurological disorders- pathology can grow in the region of the cerebral ventricles.
cysts- in patients with adenoma of the sebaceous glands, cysts of the internal organs appear. They are detected more often in the lungs, kidneys, heart.
Difficulty breathing- with rhinophyma, an enlarged nose is able to cover the upper lip. Because of this, it is difficult for the patient not only to breathe, but also to eat.

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

Crayfish

It is extremely rare that cancer can hide under the adenoma of the sebaceous glands. It is more commonly seen in older people. The reasons for its development are unknown. In appearance, a malignant formation resembles a nodule that is prone to manifestation.

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

Symptoms

A common symptom of the pathology of the sebaceous glands is the presence of a neoplasm of a nodular form. More often its size does not exceed 5-10 mm. It has a rounded shape of 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 in an unhealthy color.
Swelling- in place of the nodule, a swelling appears over time, 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 problems in development. All types of memory are broken. Sick children may experience paralysis, hydrocephalus.

With the development of a neoplasm on the head under the hair, it is difficult to detect. For many years it has been developing imperceptibly.

Diagnostics

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

Histology- from the affected area of the skin, the skin is taken by scraping it. Biological material is examined under a microscope for the presence of cancerous particles.
genetics consultation- one of the causes of the appearance of pathology is considered a genetic mutation. To minimize the risk of recurrence, it is necessary to consult a geneticist who can determine the cause of the disease.

It may also be necessary to consult with a neurologist, ophthalmologist, surgeon, oncologist. It depends on the localization of the formation, the severity of its course.

Treatment

Therapy 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 with 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 anesthesia. The defect is rejected within 2-6 weeks.
Electrocoagulation– hair electrodes are used for the procedure. The technique involves cauterization of the affected areas with an 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 neoplasm. A crust will form on it that cannot be touched. The method has a good cosmetic effect, which is important when removing adenomas in the face.
Treatment of the source disease- some neoplasms are associated with problems in the digestive system. Without their elimination, the removal of a benign formation can lead to a relapse.

During treatment, complications may develop. 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 choose a highly qualified specialist for the procedure and adhere to the recommendations received.

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sebaceous carcinoma is an aggressive but rare type of skin cancer. It usually affects the eyelid area, but it can develop anywhere else, since the sebaceous glands are present throughout the body. Often, this type of cancer is mistaken for other, less serious ailments.

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

The 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 most often painless but noticeable. Sebaceous carcinoma also causes similar, hard, painless nodules to form on the skin, but these nodules are actually malignant tumors.

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

Also, sebaceous carcinomas are usually characterized by bulge and extreme vascularization, i.e. the presence of many blood vessels. Proper diagnosis of this disease may require a biopsy. As the tumor grows in size, it may become pigmented, usually turning yellowish. This staining is due to the attachment of lipids to the tumor as it extends beyond the dermis into the epidermis. The tissues around the tumor usually become red and inflamed.

How is sebaceous carcinoma treated?

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Sebaceous carcinoma can be removed through surgery, but may also require more aggressive cancer treatments. Usually patients are recommended radiation therapy or chemotherapy, especially in the advanced stages of this disease. Sebaceous 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. At the same time, women are more susceptible to its development. It is a much rarer disease than the similar basal cell carcinoma.

Sebaceous carcinoma can also be a sign of Muir-Torr syndrome. Patients with this syndrome have several malignant skin tumors at various locations in the body, including the sebaceous glands. The most common areas of the body that are characterized by the appearance of additional tumors in Muir-Torr syndrome include the large intestine and kidneys. Thus, in the case of detection of sebaceous carcinoma, patients should be examined for the presence of other malignant tumors and observed by a doctor to be sure that Muir-Torr syndrome is absent.

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

Atheroma of the skin got its name from the Greek words meaning "tumor" and "slurry", because 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 the protein keratin, which is produced by the walls of the capsule. Atheroma of the skin 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.

Atheroma of the skin 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, trichilemmal cysts, multiple steatocystomas, but they practically do not differ in their clinical manifestations, and therefore they are all called skin atheromas.

The main symptoms of skin atheroma and possible complications

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

At a doctor's appointment, 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 with the rapid growth of the formation, it ulcerates, and a point appears in the center where the sebaceous gland was blocked.

Atheroma of the skin may remain small throughout life or begin to increase in size, be under the skin or have an excretory duct to its surface.

A complication of the disease can occur when the focus of atheroma of the skin is injured, as well as with a decrease in immunity, non-observance of personal hygiene, in patients with diabetes mellitus. In this case, suppuration of atheroma occurs, the skin turns red, swells, the focus of inflammation hurts and increases in size. If therapeutic measures are not taken in time, purulent inflammation can spread to surrounding tissues, and then abscesses and phlegmon development are likely. There is a rupture of a festering cyst in the subcutaneous tissue. Such complications of blockage of the sebaceous gland often leave rough scars after treatment. In addition, with a strong suppuration of the focus, 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 a severe complication of skin atheroma, all inflamed elements must be surgically sanitized - abscesses should be 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 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 about 3-4 mm in size, through which either the entire tumor is husked 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 closed with a cosmetic suture or plaster. Methods for removing skin atheroma using biopsy instruments are described - a round area 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 both with a scalpel and with the help of a radio wave knife or a laser beam. In the case of radio wave and laser exposure, the 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 operation technique is observed, whether the wound is closed correctly, as well as on the characteristics of the patient's skin and compliance with postoperative recommendations not to wet the wound for two days, treat it daily with an antiseptic, and protect it from traumatization.