Sebaceous carcinoma is a high-grade tumor with poor prognosis. It is often locally aggressive and may extend intracranially (from periocular sites). Metastases are seen in about 25% of cases first to regional lymph nodes and subsequently to liver, lung, brain, and bones. With metastatic spread, the 5-yr mortality approaches 50%. The image shows an admixture of basaloid cells with mature appearing sebaceous cells.