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Cureus Dec 2022A 56-year-old male with a past medical history of arachnoid cysts and with two previous brain operations and a ventriculoperitoneal shunt presented with a large left...
A 56-year-old male with a past medical history of arachnoid cysts and with two previous brain operations and a ventriculoperitoneal shunt presented with a large left lower quadrant (LLQ) abdominal mass for one year, growing rapidly for the past three months. He endorsed pus and blood leaking from ulceration on the lateral underside of the mass, and a section of the mass ruptured with blood and pus draining out on the day of admission. He denied any fevers, chills, pain, or numbness in the mass or any history of similar masses. Of note, the patient has an extensive familial history of cancer including colorectal cancer in his mother in her 30s. Computed tomography and biopsy of mass were concerning for malignancy, reporting a neoplasm in the dermis that grows in round and irregular lobules of cells along with the majority of the cells having oval nuclei with areas of sebaceous differentiation. Pathology showed sebaceous carcinoma with concern for Muir-Torre syndrome. The patient was discharged and instructed to follow up with oncology and gastroenterology.
PubMed: 36733789
DOI: 10.7759/cureus.33103 -
International Journal of Surgery Case... Jan 2023Although synchronous and metachronous tumours of the bowel are well known associations of Lynch syndrome, the association of skin malignancies in such patients are...
INTRODUCTION AND IMPORTANCE
Although synchronous and metachronous tumours of the bowel are well known associations of Lynch syndrome, the association of skin malignancies in such patients are extremely rare.
CASE PRESENTATION
A 40-year-old Sri Lankan man with a strong family history of colorectal cancer had an extended right hemicolectomy for a moderately differentiated adenocarcinoma. Two months after surgery, he developed two discrete ulcerative skin lesions in the chin and occipital region which excision biopsy confirmed to be squamous cell carcinoma. After more than two years of follow-up, patient remains disease free.
CLINICAL DISCUSSION
The Muir Torre variant of Lynch syndrome is characteristically associated with sebaceous adenomas and carcinomas, though occurence of squamous cell carcinomas are rare. In reported cases, defective mismatch repair genes associated with Lynch syndrome may suggest an increased predisposition for squamous cell carcinomas.
CONCLUSION
Patients with Lynch syndrome should be educated on the importance of seeking an early medical consult for new skin lesions and raising awareness of this rare phenomenon for physicians involved in follow up is important.
PubMed: 36512881
DOI: 10.1016/j.ijscr.2022.107822 -
Cureus Nov 2022Trichilemmal carcinoma (TC) is a rare skin malignant tumor with pillar differentiation. TC presents along with other malignant hair follicle tumors and accounts for...
Trichilemmal carcinoma (TC) is a rare skin malignant tumor with pillar differentiation. TC presents along with other malignant hair follicle tumors and accounts for only 1% of all adnexal carcinomas. TC usually occurs on sun-exposed skin in elderly people, nevertheless, it can occur at any age. We report a case of trichilemmal cyst carcinoma in a 54-year-old woman presenting with an increasing occipital cyst. A histological examination confirmed the diagnosis and a large excision was performed. Despite the absence of a well-defined consensus on the management of TC, surgical excision with adequate margins seems to be safe in the absence of metastatic lesions. However, in the case of second localization, chemotherapy could be initiated, but again, in this case, no consensus on the appropriate protocols exists.
PubMed: 36505152
DOI: 10.7759/cureus.31261 -
Thoracic Cancer Jan 2023Sebaceous carcinoma is a rare cutaneous malignant tumor, usually occurring on the eyelids, head, neck, and trunk. There have been few reports about sebaceous carcinoma...
Sebaceous carcinoma is a rare cutaneous malignant tumor, usually occurring on the eyelids, head, neck, and trunk. There have been few reports about sebaceous carcinoma with primary lung cancer, for which optimal therapy has not yet been established. A 70-year-old man presented with a mass in the left iliac bone and tumor of the lower left lung. The morphological characteristics of the iliac bone biopsy pathology and immunostaining results showed sebaceous gland differentiation. After systemic examination, we diagnosed a primary lung sebaceous carcinoma with intrapulmonary and bone metastases. PD-L1 was positive in 1%-24% of tumor cells, and microsatellites were stable. We detected protein kinase B (AKT1) mutations using the Oncomine Dx target test. Palliative radiotherapy (RT) of a total of 45 Gy was provided in 15 fractions to the left iliac region, which resulted in a 25% reduction in the tumor size. Subsequently, four courses of first-line pembrolizumab led to a 30% reduction in the total tumor count. RT and pembrolizumab may be treatment options for certain rare primary sebaceous carcinomas of the lungs. A synergistic effect from RT and subsequent administration of immune checkpoint inhibitors may have contributed to tumor reduction.
Topics: Male; Humans; Aged; Sebaceous Gland Neoplasms; Skin Neoplasms; Carcinoma; Lung; Lung Neoplasms
PubMed: 36484334
DOI: 10.1111/1759-7714.14770 -
Familial Cancer Apr 2023A subset of patients with Lynch Syndrome demonstrates cutaneous manifestations of the disorder. Characterization of these Lynch-related skin lesions could help in early... (Review)
Review
A subset of patients with Lynch Syndrome demonstrates cutaneous manifestations of the disorder. Characterization of these Lynch-related skin lesions could help in early recognition of patients with Lynch Syndrome. A broad search of the literature on OVID Medline and Embase was carried out to capture papers reporting cutaneous manifestations in Lynch Syndrome patients. The results were uploaded into Mendeley reference management software. The PRISMA workflow was used in the literature selection process. In this systematic review, data were collected from 961 cases from 413 studies, including 380 molecularly confirmed Lynch Syndrome cases. The main skin lesions were: Sebaceous adenomas (43%), sebaceous carcinomas (27%), keratoacanthomas (16%), sebaceomas (13%), squamous cell carcinomas (23%), and basal cell carcinomas (10%). MSH2 variants were the most common underlying genotype (72%). Assessment of mismatch repair by immunohistochemistry, microsatellite instability analysis, or both were performed on 328 skin lesions from 220 (58%) molecularly confirmed cases. In those skin lesions, 95% of Immunohistochemistry and 90% of the microsatellite instability test results were concordant with the underlying genotype. Sebaceous skin lesions are well-recognised phenotypic features of Lynch Syndrome. Our results show that squamous and basal cell carcinomas are relatively common in patients with Lynch syndrome; however, available evidence cannot confirm that Lynch syndrome is causal. Immunohistochemistry and/or microsatellite instability testing of skin tumours in patients with a family history of Lynch Syndrome-associated cancers may be a useful approach in identifying patients requiring referral to Clinical Genetics and/or consideration of germline genetic testing for Lynch Syndrome.
Topics: Humans; Muir-Torre Syndrome; Microsatellite Instability; Sebaceous Gland Neoplasms; Genotype; Carcinoma, Basal Cell; MutS Homolog 2 Protein
PubMed: 36418753
DOI: 10.1007/s10689-022-00319-8 -
National Journal of Maxillofacial... Aug 2022Nasal sebaceous carcinoma is an extremely rare cutaneous malignancy. We present the case of an 86-year-old female who had a skin nodule with surface telangiectasia on...
Nasal sebaceous carcinoma is an extremely rare cutaneous malignancy. We present the case of an 86-year-old female who had a skin nodule with surface telangiectasia on the right ala of the nose. The lesion had been removed and has been reconstructed with an advancement rotational flap with a minimal residual defect. Upon histopathological examination, the lesion was diagnosed with sebaceous carcinoma. The patient was followed up because of the high rate of recurrence as well as metastatic potential. No recurrence occurred during 4 years of follow-up, and the patient was unwilling to reconstruct the remaining alar defect. We present a rare skin cancer case that could be encountered during the head and neck examination by oral and maxillofacial surgeons. By reporting this case, we aimed to raise the awareness and familiarize clinicians with these less common lesions.
PubMed: 36393964
DOI: 10.4103/njms.NJMS_245_20 -
BMC Ophthalmology Nov 2022To investigate the correlation between the clinical and pathological characteristics and outcomes in patients with eyelid malignant tumors underwent wide local excision.
BACKGROUND
To investigate the correlation between the clinical and pathological characteristics and outcomes in patients with eyelid malignant tumors underwent wide local excision.
METHODS
This retrospective study included 141 cases of eyelid malignant neoplasms from January 2010 to December 2015 in Shanxi eye hospital. Demographic and clinical information were collected. The Kaplan-Meier method was used to calculate survival curves, and the log-rank test method was used to compare survival between groups. Cox proportional regression models were used to calculate the hazard ratios (HR) of total recurrence rate and metastasis rate.
RESULTS
Overall, there were 141 eyelid malignant neoplasms cases aged 65.34 ± 9.69 (range, 41-88) years old. The duration time range was from 1 to 828 (61.09 ± 122.21) months. Basal cell carcinoma (BCC) is the most common of all eyelid malignancies, accounting for 84 (59.5%), followed by Sebaceous gland carcinoma (SGC, 41, 29%), Squamous Cell Carcinoma (SCC, 11, 7.8%), Malignant Melanoma (MM, 3, 2.1%)。On cox-regression analysis, pathological classification (HR 1.959; 95% CI 1.012-3.790; p = 0.046) and eyelid tumor surgery history (HR 17.168; 95% CI 1.889-156.011; p = 0.012) were independently associated with recurrence in patients with eyelid malignant neoplasm. Pathological classification (HR 2.177; 95% CI 1.423 -3.331; p < 0.001) was independently associated with metastasis in patients with eyelid malignant neoplasm. Recurrence and metastasis were most likely to occur in 3 years after surgery.
CONCLUSION
Wide local excision is an effective and economical treatment for eyelid malignant neoplasms. The prognosis is mainly related to pathological types, eyelid tumor surgical history and TNM stages.
Topics: Humans; Adult; Middle Aged; Aged; Aged, 80 and over; Eyelid Neoplasms; Retrospective Studies; Neoplasm Recurrence, Local; Skin Neoplasms; Eyelids; China; Sebaceous Gland Neoplasms
PubMed: 36376823
DOI: 10.1186/s12886-022-02645-y -
Anais Brasileiros de Dermatologia 2023Mohs micrographic surgery is an established technique in the treatment of cutaneous neoplasms. It offers higher cure rates and the main indications are non-melanoma... (Observational Study)
Observational Study
BACKGROUND
Mohs micrographic surgery is an established technique in the treatment of cutaneous neoplasms. It offers higher cure rates and the main indications are non-melanoma malignant skin tumors. Few studies have been performed on the treatment of rare tumors through this technique.
OBJECTIVE
To study rare skin tumors and rare variants of basal cell carcinoma and squamous cell carcinoma submitted to Mohs micrographic surgery in a tertiary service in relation to frequency, disease-free evolution, and applicability of this surgical procedure for this group of tumors.
METHODS
This was a retrospective observational study including rare skin tumors and less common variants of basal cell carcinoma and squamous cell carcinoma treated using Mohs micrographic surgery, between October 2008 and April 2021.
RESULTS
During the study period, 437 tumors were treated using Mohs micrographic surgery, and 22 (5%) rare skin tumors were selected. The tumors comprised three dermatofibrosarcomas protuberans, two atypical fibroxanthomas, two spiradenomas, two hypercellular fibrohistiocytomas, one primary cutaneous adenocarcinoma, one trichoblastoma, one porocarcinoma, one chondroid syringoma, one cutaneous angiosarcoma, one Merkel cell carcinoma, and one sebaceous carcinoma. Six other cases of rare basal cell carcinoma variants with trichoepitheliomatous differentiation, metatypical basal cell carcinoma, and clear cell squamous cell carcinoma were included. There were no cases of recurrence after an average of six years of follow-up.
STUDY LIMITATIONS
This is a retrospective study on rare neoplasms carried out in a single referral center, and this surgical technique isn't widely available in the public service.
CONCLUSION
This retrospective case series showed that Mohs micrographic surgery is an appropriate treatment for rare skin tumors. They corresponded to 5% of the tumors treated by the technique during a 12-year-period, with no recurrences identified.
Topics: Humans; Retrospective Studies; Mohs Surgery; Brazil; Skin Neoplasms; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Tertiary Care Centers; Sweat Gland Neoplasms; Neoplasm Recurrence, Local
PubMed: 36369200
DOI: 10.1016/j.abd.2022.01.009 -
Eplasty 2022What is red breast syndrome (RBS)?What causes RBS?How often do patients present with RBS?What are effective treatments for RBS?
What is red breast syndrome (RBS)?What causes RBS?How often do patients present with RBS?What are effective treatments for RBS?
PubMed: 36330504
DOI: No ID Found -
Cureus Sep 2022Sebaceous carcinomas are rare malignant tumours which arise from sebaceous glands. They are subclassified into ocular and extraocular subtypes and most commonly occur in...
Sebaceous carcinomas are rare malignant tumours which arise from sebaceous glands. They are subclassified into ocular and extraocular subtypes and most commonly occur in the head and neck region. Tumours below the neck occur infrequently, and most commonly resemble benign skin lesions such as pyogenic granulomata and molluscum contagiosum, or malignant skin tumours like basal and squamous cell carcinomas (SCCs). We report a case of an 86-year-old lady presenting with a fungating breast tumour which began as a "mole" and exhibited insidious growth over five years to reach a maximum size of 10 cm. An excision biopsy was performed by the breast surgery team and histopathological analysis revealed a sebaceous carcinoma arising from the skin adnexa. On subsequent follow up, the patient was found to have a 19 mm mass in the left breast and a 20 mm mass in the right breast, which was P5 and P3 on clinical palpation, respectively. Core biopsies of left and right breast lesions showed invasive lobular carcinoma and invasive ductal carcinoma with lobular features respectively; the patient was started on primary letrozole treatment. The patient also went on to have a 2 cm wide local excision of the sebaceous carcinoma scar which was excised down to the pectoralis fascia. This is a unique presentation of a sebaceous gland carcinoma presenting as a fungating breast tumour. These tumours have a high metastatic potential and local recurrence rate, and can co-exist with primary carcinoma of the breast.
PubMed: 36237742
DOI: 10.7759/cureus.28896