Scope of the study: Sebaceous carcinoma is a rare neoplasm, arising commonly in the periocular region. They present clinically with a varied masquerade of benign lesions, thus posing diagnostic challenges to both pathologists and clinicians. This study aims to assess the histomorphological characteristics of sebaceous carcinoma. Procedure: A single centre retrospective study of a consecutive series of patients with sebaceous carcinoma of the eyelid (6 cases) diagnosed over a period of one year from November 2015 to November 2016. Results: The median age was 57 years with an equal sex incidence, but two cases occurred in young males. Initial clinical diagnoses were sebaceous carcinoma (16.7%), blepharoconjunctivitis (16.7%), chalazion (33.3%) basal cell carcinoma (16.7%) and squamous cell carcinoma (16.7%). Most of the tumours were in left eye (66.7%), poorly differentiated (50%), in upper eyelid (66.7%) with varied patterns including lobular (50%), comedo (33.3%), mixed pattern (16.7%) and were between 11 to 20mms in size (50%). A very rare case of squamoid variant was seen. Intraepithelial pagetoid spread (16.7%), recurrence (16.7%) and fatal outcome (16.7%) were seen in one case each. Tumours with poor differentiation, comedo pattern and pagetoid spread had a poor outcome. Conclusion: Our study not only corroborates previous reports of high incidence in upper eyelid, mean age at presentation and morphological features indicating poor outcome, But also emphasizes the fact that diagnosis of sebaceous carcinoma should always be considered even in young patients, without any syndromic associations, since early diagnosis and prompt surgery will lead to a better outcome
