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review\n\nPrayash Chand, MBBS, MSa , Nikol Guragain, MBBSb,*, Bhirkuti Yogi, MBBSb  \nIntroduction: Sebaceous carcinoma (SC) is an uncommon, potentially aggressive neoplasm of the sebaceous glands. Itis mostcommonly noticed in periorbital region whereas extraorbital lesions are extremely rare.  \nCase Presentation: A 52-year-old male patient presented with irregular, exophytic lesion on the scalp with posterior cervicallymphadenopathy. The reports of incisionalandexcisional biopsy suggested sebaceous carcinoma and fine needle aspirationcytology (FNAC) of lymph node was positive for malignancy. Two stages surgery by multidisciplinary team was performed followedby adjuvant radiotherapy for 8 weeks. On follow-up the patients condition was improved and is strictly being monitored for localrecurrence.  \nClinical Discussion: SC is a rare, slow growing tumor which occasionally shows aggressive behaviors. Primary site of occurrenceof SC are those with abundant sebaceous glands like eyelids, face and scalp. It presents as painless, gradually enlarging, firmsubcutaneous nodule or pedunculated lesions with tendency to ulcerate and cause spontaneous bleeding. Itis commonlymisdiagnosed as other common inflammatory dermatological conditions or tumors. For local disease, Mohs micrographic surgeryor wide local excision of the lesionis preferred, whereas radiation and systemic chemotherapy also has a place in its treatment.Conclusion: Varied presentation of sebaceous carcinoma causes delayed diagnosis or misdiagnosis which increases morbidityand mortality. Histopathological examination of any suspicious lesion is a must before or during surgery to prevent suchoccurrences.  \nKeywords: case report, extraocular, recurrence, scalp, sebaceous adenocarcinoma  \n## Introduction\n\nSebaceous carcinoma (SC) is a rare but aggressive neoplasmderived from the sebaceous gland with a tendency for bothlocal recurrence and distant neoplasm[1] . It is classified intoperi-ocular and rare extraocular types. Most sebaceous glandcarcinomashave no obvious aetiology and are thought to arisefrom de novo mutations, whereas those associated with Muir–Torre Syndrome (MTS) have associated loss of mismatch repairgene expression and exhibit microsatellite instability[2,3] . Thesetumors have a high incidence of local recurrence and regionalmetastasis, so an early diagnosis is crucial in reducing the asso -ciated morbidity and mortality[2] . Here, an aggressive sebaceouscarcinoma of scalp is presented that involved the skull, duramater, and lymph nodes, and the clinical profiles from the  \naDepartment of Plastic and Reconstructive Surgery, Patan Academy of HealthSciences, Lalitpur, Nepal and bSchool of Medicine, Patan Academy of Health  \nSciences, Lalitpur, Nepal  \nSponsorships or competing interests that maybe relevant to content are disclosedatthe end of this article.  \n*Corresponding author. Address: School of Medicine, Patan Academy of HealthSciences, Lagankhel, Lalitpur 44700, Nepal.  \nE-mail: std.nikolguragain@pahs.edu.np; guragainnikol@gmail.com (N. Guragain).Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc. This is anopen access article distributed under the Creative Commons Attribution-NoDerivativesLicense 4.0, which allows for redistribution, commercial and noncommercial, as longas itis passed along unchanged and in whole, with credit to the author.  \nAnnals of Medicine & Surgery (2026) 88:835–838Received 26 July 2025; Accepted 11 November 2025Published online 22 November 2025http://dx.doi.org/10.1097/MS9.0000000000004393  \n## HIGHLIGHTS\n\n● The report describes a highly unusual case of sebaceouscarcinoma arising from the scalp, with aggressive featuresincluding skull and dural invasion, which is exceedinglyrare for this tumor type.  \n● The lesion was initially misdiagnosed as osteomyelitis,and prior surgical specimens were not sent for histopatho -logical examin","cbCaifDMN6apoexL","https://ap.wps.com/l/cbCaifDMN6apoexL","pdf",620236,"English","# Introduction\n# Case Presentation\n# Clinical Discussion\n# Conclusion\n# Highlights\n# Case report","[{\"question\":\"What makes sebaceous carcinoma of the scalp unusual in this case?\",\"answer\":\"The report describes aggressive features uncommon for this tumor type, including skull and dural invasion, along with lymph node involvement.\"},{\"question\":\"How was the patient’s condition initially managed and why was diagnosis delayed?\",\"answer\":\"The lesion was initially misdiagnosed as osteomyelitis, and prior specimens were not sent for histopathological examination, leading to delayed diagnosis and treatment.\"},{\"question\":\"What treatment approach was used and what is the follow-up plan?\",\"answer\":\"Management included a two-stage surgical approach performed by a multidisciplinary team, followed by 8 weeks of adjuvant radiotherapy, and continued monitoring to detect local recurrence.\"}]","Aggressive sebaceous carcinoma of the scalp - a case report and literature review | PDF",1790664070]