Medical Case Reports

Sebaceous Gland Ectopia of the Esophagus: A Challenging Clinical Diagnosis

Sebaceous Gland Ectopia (SGE) is a term defining the presence of normal sebaceous tissue in an unusual location. This condition is rare and first has been described in ectodermal derived organs such as in oral cavity, palms and other locations. SGE has also been described in endodermal derived tissues including the esophagus. However, this latter condition is extremely rare and to date only a few cases have been reported in English medical literature. This phenomenon is believed to represent a form of acquired metaplasia. SGE is asymptomatic and usually is discovered during routine endoscopic examinations for other gastrointestinal complains and symptoms.

SGE is a benign entity and to date no cases of malignant transformation have been reported. Due to its benign nature, once the diagnosis of SGE has been confirmed, no further work up or follow up is necessary. There is also no need to treat this condition. However, careful histopathology examination is important to differentiate this entity from malignant and infectious conditions, which are more common and can be clinically and endoscopically similar. In this report we present two cases of SGE arising in the esophagus of two female patients, who presented with complaints of gastro-esophageal reflux and underwent endoscopy.

These lesions presented as patchy yellow-white nodules in the mid and upper esophagus and they were endoscopically interpreted as suggestive of candidiasis or glycogen acanthosis. Biopsies showed foci of non-keratinizing squamous mucosa overlying sebaceous glands. These glands exhibited a characteristic lobulated structure with germinative cells at the periphery and vacuolated well differentiated cells in the center of the lobules. After careful histologic examination and special stains the endoscopic impressions of candidiasis and acanthosis were ruled out and the final diagnosis of sebaceous ectopia was made. There was no evidence of dysplasia or malignancy in our cases.

Author(s): Antonietta Baffa, Domenico Coppola

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