Clinicopathological Insights into Sebaceous Lesions: A Retrospective Analysis of 19 Cases at a Tertiary Care Centre of Uttarakhand

Abstract Introduction: Sebaceous lesions encompass a wide spectrum of benign and malignant tumours, often presenting diagnostic challenges due to overlapping clinical, cytological and histopathological features. This study aimed to analyse the clinicopathological characteristics of sebaceous lesions, evaluate diagnostic concordance among clinical, cytological and histopathological findings and identify discrepancies to enhance diagnostic accuracy. Methods: A retrospective analysis of 19 cases of sebaceous lesions diagnosed on histopathology between 2014 and 2024 was conducted. Clinical, cytological and histopathological data were reviewed and correlated. Descriptive statistical analysis was used to summarise demographic and clinicopathological data. Results: The face was the primary site (68.4%, 13/19), with the cheek most affected (26.3%, 5/19). Clinical presentations ranged from nodules and cystic swellings to unique manifestations such as eyelash loss and facial nodules in tuberous sclerosis. Cytological evaluation, performed in seven cases, showed limited specificity, with notable discrepancies in two cases. Overall, sebaceoma was the most common diagnosis (42%, 8/19), followed by sebaceous adenoma (26.3%, 5/19). Rarer entities included pigmented trichoblastoma with sebaceous differentiation, trichofolliculoma with sebaceous differentiation, sebaceous carcinoma and nevus sebaceous. Five cases clinically diagnosed as epidermal inclusion cysts were histologically confirmed as sebaceoma. Similarly, one case clinically suspected as basal cell carcinoma was identified as pigmented trichoblastoma on histopathology. Conclusion: This study underscores the diagnostic challenges in sebaceous lesions, highlighting the indispensable role of histopathology in cases with ambiguous clinical or cytological findings. Collaborative efforts between clinicians and pathologists, coupled with advanced diagnostic techniques, are essential for improving diagnostic accuracy and ensuring optimal patient management.