Sebaceous adenomas are most commonly found on the head and neck, which is where sebaceous glands are particularly abundant. Rarely, they may present on other hair-bearing areas of the body, including the trunk and the legs. There are also rare reports of lesions on the oral mucosa.
Although considered rare, the actual incidence of sebaceous adenomas is unknown. There is no racial predilection or increased incidence in a particular geographical location. Sebaceous adenomas frequently appear after the age of 50, with an average age of onset of 60. They typically affect men and women equally. These benign neoplasms do not have the potential for aggressive growth or metastasis, although local recurrence may occur after incomplete removal of the tumor.
The presence of a sebaceous adenoma can be concerning for possible underlying visceral malignancies, usually of the gastrointestinal tract, due to its association with Muir-Torre syndrome (MTS).
D23.9 – Other benign neoplasm of skin, unspecified
307598005 – Sebaceous adenoma of skin
Differential Diagnosis & Pitfalls
- Sebaceous gland hyperplasia – Small, yellow papule with central umbilication (sebaceous adenomas demonstrate umbilication less frequently). A small globule of sebum can be expressed from the umbilicated opening in sebaceous hyperplasia. Additionally, dermatoscopy reveals overlying telangiectasias (often seen in sebaceous gland hyperplasia but not found in sebaceous adenomas). Sebaceous adenomas have an increased number of basaloid cells.
- Sebaceous carcinoma – Most frequently arises on the eyelids or around the eyes. Found on an eyelid in about half of cases; histology shows dermal aggregates of atypical, poorly differentiated polyhedral tumor cells separated by fibrovascular stroma.
- Basal cell carcinoma – Shows a higher proportion of basaloid cells and a fibromyxoid stroma.
- Sebaceoma – Seboblasts predominate in sebaceomas and often involve the deeper dermis, whereas sebaceous adenomas are more superficial neoplasms that have a predominance of sebocytes.
- Nevus sebaceus
- Sebocrine adenoma