Periocular Sebaceous Carcinoma: A Rare Entity in Mexico

Sebaceous carcinoma (SC) is a malignant neoplasm arising from the sebaceous glands.Its periocular location, originating from the meibomian or Zeis glands, can clinically mimic benign lesions such as chalazion or chronic blepharitis, which may delay diagnosis.We present a case of an elderly male patient with a history of nodular basal cell carcinoma, type 2 diabetes mellitus, and systemic arterial hypertension, who presented to the dermatology clinic with an asymmetric neoformation on the right lower eyelid, reddish in color with whitish-yellow areas and ulceration with a hematic crust.Dermoscopy showed polymorphic vessels and structureless yellowish areas.Histopathological examination revealed a malignant epithelial tumor with clear-cytoplasm cells, pleomorphic nuclei, and focal necrosis, with sebaceous differentiation confirmed by immunohistochemistry positive for epithelial membrane antigen (EMA).Surgical resection with a wide safety margin and reconstruction using a Mustardé flap were performed, achieving tumor-free histological margins.Clinical and imaging follow-up showed no evidence of recurrence or metastasis.In this patient, wide local excision with complete histopathological evaluation confirmed complete removal of the lesion with clear surgical margins, with no evidence of recurrence during follow-up.