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Dermatology Practical & Conceptual Apr 2017Myxoid melanoma is a rare variant of melanoma, which is characterized by atypical spindle cells and dense mucin deposition in dermis. This tumor is usually seen in...
Myxoid melanoma is a rare variant of melanoma, which is characterized by atypical spindle cells and dense mucin deposition in dermis. This tumor is usually seen in elderly people with a similar progress in other variants of melanoma. A 28-year-old male presented to our outpatient clinic with a 6-month history of a slowly growing asymptomatic pink lesion on his arm. Dermoscopic examination revealed pink-white cristalline structures and blue-grayish ovoid globules. The lesion was totally excised with initial diagnosis of basosquamous carcinoma, amelanotic melanoma and basal cell carcinoma. Histopathological examination was consistent with myxoid melanoma. We present this case due to the rarity of myxoid melanoma and occurrence at such a young age.
PubMed: 28515997
DOI: 10.5826/dpc.0702a13 -
International Wound Journal May 2022The study spotlights a severe uncommon post-burn complication, Marjolin's ulcer, in upper Egypt plastic and wound care centres. This problem is mainly related to... (Review)
Review
The study spotlights a severe uncommon post-burn complication, Marjolin's ulcer, in upper Egypt plastic and wound care centres. This problem is mainly related to inadequate medical care and awareness. No community or race is immune. The underlying malignant transformation mechanism remains unclear. The study aims, according to our experience, to review the prognostic factors through the management protocol of Marjolin's ulcers. This prospective study was conducted in the Aswan University Plastic & Burn surgery department in South Egypt between 2013 and 2020 and investigated 226 patients with chronic post-burn ulceration. Nineteen cases were proved to have Marjolin's ulcer, and the other cases that had been excluded from being malignant went for reconstruction with split-thickness skin graft with/without flap after adequate ulcer debridement. The surgical, oncologic, radiologic indications, and prognostic factors were reviewed according to our management outcome-the assessment with follow-up period extended over 5 years. Histopathology of ulcers ranged among mild, moderate, and poorly differentiated squamous cell carcinoma. One scalp ulcer case showed basosquamous pathology. Most cases presented at age above 50, but no age was immune. The mean latent period was 29 years on average. The lesions' sites varied in their anatomic location where they involved the upper extremity, the scalp, and the lower extremity that had a predilection. Although surgical excision is the primary management line for tumour ablation, other factors may change the management course. During the follow-up period, neoplasm recurrence in the form of lymph node enlargement and/or locoregional metastasis was detected in eight cases. Within 1 year after the intervention, six recurrent cases died, and two were saved. In addition to the case study, this paper reviewed the literature and provided our team a good experience in light of the NCCN protocol for non-melanotic cutaneous carcinoma, although we suffered limited medical resources. It is concluded that early accurate diagnosis, low-grade malignancy, and well-planned individualised surgery with adjuvant radiotherapy were the best prognostic factors. The close follow-up for an early sign of disease recurrence is paramount.
Topics: Carcinoma, Squamous Cell; Cicatrix; Humans; Neoplasm Recurrence, Local; Plastics; Prospective Studies; Skin Neoplasms; Skin Ulcer; Ulcer
PubMed: 34535972
DOI: 10.1111/iwj.13690 -
Medicina (Kaunas, Lithuania) Feb 2023Basosquamous cell carcinoma (BSCC) is a rare malignancy usually arising on sun-exposed areas of the skin. BSCC is described as a rare variant of Basal cell carcinoma...
Basosquamous cell carcinoma (BSCC) is a rare malignancy usually arising on sun-exposed areas of the skin. BSCC is described as a rare variant of Basal cell carcinoma (BCC) which shows clinical and microscopic features of both BCC and of Squamous cell carcinoma (SCC). We report the case of a 70-year-old male with a cutaneous lesion of the nipple-areola complex (NAC); to the best of our knowledge, this is the first ever reported patient with BSCC in this area. The lesion had a fast growth, but, due to the COVID19 crisis, the patient only came to our observation one year after onset of this condition. Physical examination showed a bleeding red ulcerated lesion that involved the NAC, measuring 27 mm × 20 mm. Biopsy showed a BSCC. Pre-operative breast ultrasound scan, mammogram and MRI were all performed before surgery, which consisted of simple mastectomy and sentinel lymph-node biopsy. The patient was discharged home on the 4th post-operative day, and at 18-month follow-up there are no signs or clinical evidence of local recurrence or metastases. Diagnosis of BSCC of the nipple-areola complex requires high index of suspicion and a thorough differential diagnosis, management, and suitable radical treatment due to well described high rates of recurrence and of metastases. Differential diagnosis with similar lesions (e.g., Paget's disease, Bowen's disease, BCC, and SCC) should also be taken into account.
Topics: Male; Humans; Aged; Nipples; Breast Neoplasms; Mastectomy; COVID-19; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Skin Neoplasms
PubMed: 36837518
DOI: 10.3390/medicina59020316 -
Iranian Journal of Pathology 2015Clinical behavior of basal cell carcinoma (BCC) is known to be different according to histological growth pattern and basosquamous cell carcinomas (BSC) are known with...
BACKGROUND AND OBJECTIVE
Clinical behavior of basal cell carcinoma (BCC) is known to be different according to histological growth pattern and basosquamous cell carcinomas (BSC) are known with their aggressive behavior and metastatic capacity. In this study, we evaluated bcl-2 and cyclin D1 expressions in BCC and BSC cases comparatively, to explore their predictive value on the aggressive behavior of these tumors.
METHODS
One hundred tumors belong to 92 patients diagnosed as basal cell carcinoma and basosquamous carcinoma were studied. Basal cell carcinomas were classified as aggressive and non-aggressive types according to growth pattern. Number of Cyclin D1 and bcl-2 positive cells in immunohistochemically stained serial sections were scored as low (0-1 +) and high (2 and 3+) in all tumors.
RESULTS
A statistically significant difference was found between non-aggressive (nodular type) and aggressive types (micronodular, infiltrative types and BSC) for these markers ( P <0.005). Cyclin D1 was higher in the aggressive group, while bcl-2 was lower in the aggressive group compared to the non-aggressive group.
CONCLUSION
Higher Cyclin D1 and lower bcl-2 scores was correlated with aggressive tumor types and these results could be used as markers to predict aggressive behavior in BCC and BSCs.
PubMed: 26351483
DOI: No ID Found -
Indian Journal of Ophthalmology Jun 2022To provide a retrospective analysis of lesions of the caruncle which have been very rarely reported in the literature.
PURPOSE
To provide a retrospective analysis of lesions of the caruncle which have been very rarely reported in the literature.
METHODS
A retrospective review of all the caruncular lesions between January 2000 and January 2020 was done at a single tertiary eye care hospital. The lesions were classified as benign and malignant lesions. Clinicopathological correlation was done for the excised lesions.
RESULTS
A total of 87 caruncular lesions were included in the study. Males (59%) were affected more than females (41%). The mean age at presentation was 44 ± 20 years. The mean duration of complaint was 36 ± 62 months. A total of 36 patients underwent surgical excision whereas the rest opted for conservative management. Recurrence was noted in five patients. Fifteen different types of lesions were identified histopathologically. Benign lesions (78%) were far more common than malignant ones (22%). Epithelial inclusion cyst was the most common benign lesion and sebaceous gland carcinoma was the most common malignant lesion. Correct clinicopathological correlation was seen in 52.7% of the cases. Caruncular tuberculosis, oncocytoma, and basosquamous cell carcinoma were some of the rare lesions.
CONCLUSION
Caruncular lesions are uncommon and very diverse, which makes clinical diagnosis challenging. Epithelial inclusion cyst and sebaceous gland carcinoma were the most common benign and malignant lesions respectively. Correct clinicopathological correlation was seen in more than half of the cases.
Topics: Adenocarcinoma, Sebaceous; Conjunctiva; Cysts; Female; Humans; Male; Retrospective Studies; Sebaceous Gland Neoplasms
PubMed: 35647965
DOI: 10.4103/ijo.IJO_2724_21 -
Biomedicines Oct 2023(BCC) is a skin cancer with low local aggressiveness and a low tendency to metastasize. (BSC) represents an aggressive histological subtype of BCC with intermediate...
(BCC) is a skin cancer with low local aggressiveness and a low tendency to metastasize. (BSC) represents an aggressive histological subtype of BCC with intermediate features between (SCC) and BCC. Cemiplimab is currently approved as first-line therapy in SCC and second-line therapy in BCC patients who have progressed on or are intolerant of a Hedgehog pathway Inhibitor (HHI). Our study describes the case of a 59-year-old man with BSC who was successfully treated with 5 cycles of Cemiplimab as first-line therapy and Sonidegib as second-line therapy. Currently, the efficacy of Cemiplimab against BSC and other histopathological subtypes of BCC has not been fully elucidated, as has the role of sequential or combination therapy with Cemiplimab and HHI in the management of BSC. The aim of this case report is to highlight the need to outline the use of checkpoint inhibitors in BCCs and focus attention on the synergistic role of Cemiplimab and HHIs in such a controversial entity as BSC.
PubMed: 38001904
DOI: 10.3390/biomedicines11112903 -
Dermatologic Therapy Jun 2022
Topics: Antineoplastic Agents; Biphenyl Compounds; Carcinoma, Basal Cell; Carcinoma, Basosquamous; Humans; Pyridines; Skin Neoplasms
PubMed: 35278014
DOI: 10.1111/dth.15436 -
Journal of Skin Cancer 2018Basosquamous carcinoma (BSC) is an uncommon skin malignancy with significant invasive and metastatic potential. There are currently no clear management guidelines. This...
Basosquamous carcinoma (BSC) is an uncommon skin malignancy with significant invasive and metastatic potential. There are currently no clear management guidelines. This study evaluates the management and outcomes of patients diagnosed with BSC over a 7-year period. We present an evidence-based unit protocol for the management of BSC. All patients treated for BSC between 2009 and 2015 were reviewed. Data collected included patient demographics, tumour-specific information, management strategy, presence of recurrence or metastasis, and details of follow-up. 74 patients were identified, making this one of the largest cohorts of BSC patients reported. Mean age at diagnosis was 75.4 years, with a male:female ratio of 1.6:1. The most common tumour site was the head and neck (n=43, 58.1%). All tumours were graded at pT1 (n=51) or pT2 (n=23). Inadequate excision occurred in 17 patients (23%). Mean excision margins were >4mm peripherally and deep. Inadequately excised BSCs were further treated with wide local excision (n=6) or radiotherapy (n=5), or both (n=1). There were no cases of local recurrence or metastatic disease. This study demonstrates a cohort of patients with BSCs that appear less aggressive than previously reported. Current management with surgical excision appears to produce adequate results. However, an evidence-based guideline is still lacking.
PubMed: 29973992
DOI: 10.1155/2018/6061395 -
Sisli Etfal Hastanesi Tip Bulteni 2021Scalp defects may occur following trauma, radiotherapy, oncologic resection, and recurrent surgeries. The hair-bearing scalp has a dual role, which consists of...
OBJECTIVE
Scalp defects may occur following trauma, radiotherapy, oncologic resection, and recurrent surgeries. The hair-bearing scalp has a dual role, which consists of protecting the calvarium and contributing to aesthetic appearance. While the "reconstructive ladder" approach may be used to close small and medium-sized scalp defects, it is not the case for larger ones involving the calvarium or with a radiation therapy history. The aim of this study is to present cases operated due to complex scalp defects, analyze complications, and discuss the choice of reconstruction.
MATERIAL AND METHODS
The study consists of 14 patients who were operated between December 2017 and August 2019 due to a complex scalp defect. Patient were evaluated according to age, gender, etiology, radiation therapy history, defect size and location, reconstruction steps, cranioplasty and duraplasty options, type of free flap, recipient artery, vein graft requirement, and complications.
RESULTS
The mean age of patients, which consists of 11 men and three women, was 56.7 years. The etiology for scalp defects included basosquamous carcinoma, squamous cell carcinoma, giant basal cell carcinoma, atypical meningioma, glioblastoma multiforme, angiosarcoma, and anaplastic oligodendroglioma. The defect involved the full thickness of calvarium in nine cases and pericranium in five cases. Cranioplasties were made with rib graft (=1), bone graft (=1), and titanium mesh (=7). Free flaps used for reconstruction were musculocutaneous latissimus dorsi (LD) (=4), LD muscle (=3), anterolateral thigh (ALT) (=4), musculocutaneous ALT (=1), vastus lateralis muscle (1), and rectus abdominis muscle (=1). Flap loss was not observed. Complications occurred in four of the patients; include a partial graft loss, a wound dehiscence, seroma, and an unsatisfactory esthetic result.
CONCLUSION
Free tissue transfers rather than local flaps should be opted to reconstruct complex scalp defects, as failure of the latter, could create much greater defects, and worse consequences. There are many options for proper reconstruction, and it is essential to select the appropriate one, taking into account the comorbid conditions of each case.
PubMed: 34712077
DOI: 10.14744/SEMB.2020.98475 -
Animals : An Open Access Journal From... Apr 2023In the present study, the histological characteristics of squamous cell carcinomas (SCCs) and basal cell carcinomas (BCCs) obtained from 22 squamate and 13 chelonian...
In the present study, the histological characteristics of squamous cell carcinomas (SCCs) and basal cell carcinomas (BCCs) obtained from 22 squamate and 13 chelonian species were retrospectively evaluated. While the examined tissues were originally diagnosed as 28 SCCs and 7 BCCs based on histological evaluation by a specialty diagnostic service, eight SCCs could be re-classified as BCCs and three SCCs proved to be non-neoplastic lesions. In addition, all SCCs and BCCs were classified into distinct histological variants. The SCCs could be categorized as one SCC in situ, three moderately differentiated SCCs, seven well-differentiated SCCs, and six keratoacanthomas. BCCs were classified as five solid BCCs, four infiltrating BCCs, five keratotic BCCs, and one basosquamous cell carcinoma. In addition, the present study reports the occurrence of BCCs in seven reptile species for the first time. In contrast to what has been documented in humans, IHC staining with the commercially available epithelial membrane antigen and epithelial antigen clone Ber-EP4 does not allow differentiation of SCCs from BCCs in reptiles, while cyclooxygenase-2 and E-cadherin staining seem to have discriminating potential. Although the gross pathological features of the examined SCCs and BCCs were highly similar, each tumor could be unequivocally assigned to a distinct histological variant according to the observed histological characteristics. Based on the results of this study, a histopathological classification for SCCs and BCCs is proposed, allowing accurate identification and differentiation of SCCs and BCCs and their histological variants in the examined reptile species. Presumably, BCCs are severely underdiagnosed in squamates and chelonians.
PubMed: 37106890
DOI: 10.3390/ani13081327