Treating a cancerous sebaceous cyst (sebaceous carcinoma) primarily involves surgery to remove the tumor and surrounding tissue, often using techniques like Wide Local Excision (WLE) or specialized Mohs Micrographic Surgery (MMS) to ensure clear margins, with potential follow-up using radiation or chemotherapy if cancer has spread; a biopsy confirms the diagnosis, and an ophthalmologist may examine the eye if located there, as it's a common site.
Surgery is the main treatment. Your surgeon aims to remove all the cancer cells and some healthy tissue around it (a healthy margin). The surgeon might not know the extent of your cancer before surgery. So they might need to remove more tissue than expected.
If the cyst swells and/or causes discomfort, use a warm compress over the cyst to reduce symptoms at home. If your symptoms continue or get worse, contact a provider. They may recommend removing it, or they'll inject a steroid medication into the cyst to temporarily reduce swelling.
If a cyst is cancerous, treatment will depend on its size and location and on whether or not cancer cells have spread to other parts of the body. The cyst will be surgically removed along with surrounding tissue. Further treatment might include radiotherapy (using x-rays to kill cancer cells) or chemotherapy (drugs).
Historically, wide local excision (WLE) was the mainstay of treatment for sebaceous carcinoma. However, recent developments advocate Mohs micrographic surgery (MMS) as a more favorable option.
When sebaceous carcinoma develops elsewhere on the body, it is usually on the head or neck, and sometimes on the genitals, ear canal, breasts, chest, back, abdomen or buttocks. It looks like a slowly growing pink or yellowish lump and may bleed.
Cysts that appear uniform after an ultrasound exam or a CT scan are almost always benign and should simply be watched. If the cyst has solid components, it may be benign or malignant and should have further evaluation. Often this is done with repeat imaging to see if the cyst grows over time.
An MRI can provide clues, but it can't definitively tell if a tumor is benign or malignant without further testing like a biopsy.
If you find a lump, don't panic. A majority of these are benign, which often feel like a round, smooth rubber ball. Malignant lumps, on the other hand, are irregular, firm and unable to be moved.
But if a cyst is bothering you for any reason, see your healthcare provider. A cyst can be injected with steroids. This can reduce inflammation and the cyst may not need to be drained. But infected cysts may need to be cut and drained.
Sebaceous cysts can develop if the sebaceous glands get damaged or blocked. This usually happens from some sort of trauma like a scratch, a surgical wound or a skin condition like acne.
By the fourth week, most patients heal completely from sebaceous cyst removal surgery. The patient still needs to monitor the wound area for any signs of infection or complications as a precaution. The patient can resume most activities but still have to avoid heavy lifting or other strenuous activities for a while.
In some cases, topical medications can help manage sebaceous cysts. Over-the-counter creams containing salicylic acid or benzoyl peroxide can help keep your skin clear and free from bacteria that could cause infections.
If a cyst becomes red, swollen, warm to the touch, or increasingly painful, it may indicate an infection. Infected cysts can lead to complications and require medical treatment.
Sebaceous cysts are slow-growing and are usually non-cancerous. However, there may be some cases in which the cyst is classified by a dermatologist as abnormal. These abnormal cysts are biopsied and tested for cancer.
A cancerous lump is usually hard, not soft or squishy. And it often has angular, irregular, asymmetrical edges, as opposed to being smooth, Dr. Comander says. In order for you to feel a cancerous lump, it probably has to be rather large and closer to the surface of the skin.
Doctors can't always tell if a tumor is cancerous just by looking. Some tumors might look suspicious, but a biopsy is needed for sure.
Some cysts can be felt with your hand, but some are deeper inside the body and can only be seen with x-rays or other imaging tests. If a cyst is in a spot where you can see and feel it, it may be soft or pliable to the touch if it contains air or fluid. But if it is filled with tissue, it can feel more firm and solid.
Can a cyst become cancerous? Most cysts are benign and do not become cancer. However, rare types of cancer—like sebaceous skin cancer or cystic basal cell skin cancer—can resemble common cysts. It's important to monitor any lump that grows quickly, changes in shape, becomes painful, or appears solid rather than soft.
Diagnosis. Depending on the location and how close to the surface the growth is, your doctor may recognize a cyst or tumor during a physical exam. However, imaging tests like ultrasound, CT, MRI, or mammograms in the case of breast lesions, are usually the best method for distinguishing between a benign cyst and cancer ...
In most cases, the answer is no. Simple cysts are almost always benign, and complex or complicated cysts are usually benign as well — but not always. “In rare cases, a complex or complicated cyst can harbor malignant cells,” says Dr. Racz.
Blood tests, a biopsy, or imaging—like an X-ray—can determine if the tumor is benign or malignant.
Cysts can appear anywhere, but generally appear on the face, neck, trunk and genital area.
In addition, if a cyst is filled with pus, that means it's infected and could form an abscess, so you should see a doctor if you feel pain when you touch a cyst.