台耳醫誌

Sebaceous carcinoma (SC) is a rare and highly malignant skin cancer that commonly develops on the eyelids, head, neck, and trunk. This case report presents a 62-yearold male kidney transplant recipient on long-term immunosuppressive therapy who developed an extremely rare SC lesion over the nasal ala. The initial lesion was a sebaceous adenoma, but SC was confirmed after multiple recurrences and biopsies. The patient ultimately underwent wide excision and reconstructive surgery, and pathological results confirmed complete tumor removal. The mechanisms linking immunosuppression to SC are also reviewed, including impaired immune surveillance, the carcinogenic effects of immunosuppressants, and their potential association with microsatellite instability and Muir–Torre syndrome (MTS). The risk of SC in solid organ transplant recipients is reportedly 25 times higher than in the general population. In immunosuppressed individuals, rapidly growing and recurrent skin lesions should raise high suspicion of malignancy, and early wide excision is recommended for accurate diagnosis and to reduce recurrence. Further research is needed to explore the role of oncogenic viruses and immunosuppressive drugs in SC pathogenesis. (J Taiwan Otolaryngol Head Neck Surg 2026; 60:145-150)