Sebaceous carcinoma (SC) typically arises in the periocular region but on rare occasions can present within the oral cavity, posing diagnostic and therapeutic challenges. This report describes a 50-year-old male who developed a progressively enlarging ulcero-proliferative lesion in the right buccal mucosa, initially misdiagnosed as squamous cell carcinoma. Histopathological re-evaluation, supported by immunohistochemistry (CK5/6, p63, and epithelial membrane antigen positivity), established the diagnosis of SC, confirming sebaceous differentiation. Despite its atypical location, the tumor behaved aggressively, invading the mandible and necessitating a composite resection and neck dissection, followed by reconstruction with a pectoralis major myocutaneous flap. Postoperative recovery was uneventful, highlighting the efficacy of prompt surgical intervention when diagnosis is accurate. This case underscores the importance of considering SC among differential diagnoses for oral cavity lesions, especially when histological and immunohistochemical findings diverge from common oral malignancies. A collaborative effort among pathologists, radiologists, and surgeons remains critical for early detection, appropriate management, and improved patient outcomes.
Umadevi et al. (Thu,) studied this question.