Extraocular Sebaceous Carcinoma of the Toe in a Young Adult: A Case Report.

Abstract

Background: Sebaceous carcinoma is a rare and potentially aggressive malignant adnexal tumor, most commonly occurring in the periocular region. Extraocular presentations, particularly involving the extremities, are uncommon and may pose diagnostic and management challenges due to their non-specific clinical appearance.

Case Presentation: We report the case of a 22-year-old female who presented with a chronic non-healing lesion over the medial aspect of the right big toe. The lesion had been present for two years with progressive enlargement. Initial excision and skin grafting were performed at an outside hospital; however, histopathology revealed positive surgical margins, and the wound failed to heal. Further evaluation confirmed sebaceous carcinoma with deep margin involvement. The patient was referred to a tertiary care center, where a definitive wide local re-excision achieved clear margins. The surgical defect entirely healed by secondary intention without the need for further reconstruction.

Conclusion: This case highlights an unusual presentation of extraocular sebaceous carcinoma in a young patient and underscores the importance of early suspicion, accurate histopathological diagnosis, and complete surgical excision with clear margins. Adequate oncologic management can result in favorable outcomes even in rare and atypical presentations.