Amelanotic lentigo maligna melanoma: report of a case and review of the literature.

Amelanotic lentigo maligna melanoma (ALMM) is an infrequent presentation of lentigo maligna melanoma, less than thirty cases having been reported to date. Hypopigmented or erythematous macules on the face of older women, resembling Bowen's disease or eczema, are the most common clinical presentation. We report a case of ALMM in a 73-year-old woman. Therapeutic trials with cryotherapy, 5-fluorouracil, and azelaic acid were unsuccessful, and the lesions were eventually cured by surgical excision. ALMM requires early clinical suspicion and histopathologic confirmation of diagnosis in every patient presenting with a slowly enlarging erythematous or hypopigmented macule, especially when located on the face of an older woman with a light complexion.     

Amelanotic lentigo maligna melanoma of the face: a case report and review of the literature

Amelanotic lentigo meligna melanoma is rare, only 10 cases over the face having been reported to date in the English literature. In none of these was the diagnosis suspected clinically, being made in all cases only after histopathological examination. We now report an unusual additional case of this uncommon lesion, which quickly progressed from an amclanotic lentigo maligna to an invasive melanoma in a short space of time, and review the literature concerning this condition.     

Amelanotic lentigo maligna melanoma: a unique case and review of the literature

It has been estimated that 2 percent of all melanomas are clinically amelanotic, with amelanotic lentigo maligna melanoma being an even rarer presentation. These neoplasms have presented clinically as neurodermatitis, eczema, and erythema. Given the lack of clinical markers and subsequent delay in diagnosis of these lesions, they are potentially more dangerous than pigmented lentigo maligna melanomas. We report a case of an amelanotic lentigo maligna melanoma presenting as an ill-defined edematous area on the left cheek of an elderly woman.     

Metastatic basal cell carcinoma: case series and review of the literature

Metastatic basal cell carcinoma is exceedingly uncommon, with a poorly defined natural history, and its incidence, risk factors, patterns of spread, prognosis and potential treatment options are not well understood. This retrospective single institution case series aims to shed light on these issues. Aggressive local management in patients with locoregional disease may result in long‐term survivors.     

Axillary basal cell carcinoma: case report and literature review

Axillary basal cell carcinoma (BCC) has been rarely reported. The axilla is a site that is less likely to be monitored by the patient, thus there is a potential for delay in diagnosis and treatment. Surgical excision is the most widely used treatment method for its effectiveness, simplicity and histologic control. BCC is easily treated when it is detected early. There are 33 cases of axillary BCCs reported in the literature, and only one case has been reported in Asia. Herein we report on the second case of primary axillary BCC in an Asian female.     

Basal cell carcinoma surrounded by lentigo maligna

A case of nodular basal cell carcinoma occurring within a lentigo maligna is reported. This case illustrates the fact that not all nodules appearing within a lentigo maligna are melanoma.     

Amelanotic lentigo maligna and amelanotic lentigo maligna melanoma: a report of three cases mimicking intraepidermal squamous carcinoma

The clinical diagnosis of amelanotic melanoma may pose diagnostic difficulties. We report three cases of amelanotic lentigo maligna, two of which developed an invasive component (lentigo maligna melanoma). The clinical appearances in each case mimicked intraepidermal squamous carcinoma.     

Clear cell basal cell carcinoma with pulmonary metastasis: case report and literature review

Clear cell basal cell carcinoma is a rare histological variant of basal cell carcinoma, which has been well described in the literature. We herein report a case of a 56-year-old man who developed lung metastasis from a rather aggressive tumor that grew very rapidly to involve the parotid gland, the mandibular bone, and even the petrous portion of the temporal bone, the middle ear, and the dura mater. Histological diagnosis was clear cell carcinoma, and initially a salivary origin was suspected. Only in the resection specimen, we found areas of more conventional basal cell carcinoma, and final diagnosis was clear cell basal cell carcinoma. We herein report a case of this rare variant and comment on the histopathological differential diagnosis and the possible relation between these tumors and Gorlin-Goltz syndrome.     

Management of lentigo maligna and lentigo maligna melanoma with staged excision: a 5-year follow-up

OBJECTIVE: To assess the long-term cure rate for treatment of lentigo maligna (LM) and lentigo maligna melanoma (LMM) by means of a staged, margin-controlled, vertical-edged excision with rush permanent specimens and a radial sectioning technique. DESIGN: Retrospective follow-up study. SETTING: University-affiliated and private-practice dermatologic surgery clinics. PATIENTS: Fifty-nine patients treated for 55 LMs and 7 LMMs between January 1, 1990, and December 31, 2001. INTERVENTIONS: The technique included vertical excision with initial 2- to 3-mm margins examined by rush permanent sections (prepared and read within 24 hours). Further excision took place as guided by histologic findings. Data on patient and lesion characteristics were obtained via a medical chart review. Patients were then contacted and examined for local recurrence. Biopsies were performed on all patients with possible recurrence on clinical examination. MAIN OUTCOME MEASURES: Local recurrence of LM or LMM. RESULTS: After a mean follow-up of 57 months (median, 54 months; 293.8 person-years), 95% of patients were free of recurrence. Three patients had local recurrence and no patients had evidence of metastasis. Two of the 3 local recurrences were of previously excised LM, and 1 was of an LMM. Half (32) of all lesions required 2 or more stages. One required more than 4 stages. The average margin of excision was 0.55 cm. Three of the 58 lesions read as LM on biopsy were found to have invasive disease (LMM) at the time of definitive excision. CONCLUSIONS: The technique described herein for the treatment of LM and LMM provides a long-term disease-free survival of 95%. The cure rate is greater than that reported for standard excision and is similar to that for other margin-control techniques. To our knowledge, this is the largest reported study and has the longest follow-up for this excision method for LM and LMM.     

Radiotherapy for lentigo maligna: a literature review and recommendations for treatment

Lentigo maligna (LM) incidence is increasing. LM frequently involves the face near critical anatomical structures and as a consequence clinical management is challenging. Nonsurgical therapies, including radiotherapy (RT), are increasingly used. Evidenced‐based treatment guidelines are lacking. We conducted a review of previously published data analysing RT treatment of LM. A search of PubMed, Embase and Medline databases to June 2012 identified nine clinical studies that examined the use of RT for LM treatment in at least five patients. Nine studies described 537 patients with LM treated with definitive primary RT, between 1941 and 2009, with a median reported follow‐up time of 3 years. Eight articles could be reviewed for oncological outcome data. There were 18 recurrences documented in a total of 349 assessable patients (5%). Salvage was successful in the majority of recurrent LM cases by using further RT, surgery or other therapies. Progression to LM melanoma (LMM) occurred in five patients (five out of 349, 1·4%) who all had poor outcomes. There were five marginal recurrences documented out of 123 assessable patients (4%). There were eight in‐field recurrences documented with either LM (five) or LMM (three) out of 171 assessable patients (5%). A series of recommendations were then developed for RT parameters for treatment of LM. These parameters include treatment volume, dose, dose per fraction and outcome measures. These may be of use in prospective data collection.     

Cutaneous basal cell carcinosarcoma: case report and literature review

Carcinosarcomas are malignant neoplasms with biphasic carcinomatous and sarcomatous or sarcoma‐like components. In general, the sarcomatous component is accepted to be the result of divergent mesenchymal differentiation of the epithelial component. Although well characterized in some anatomic locations (e.g. uterus, upper aerodigestive tract and lung), carcinosarcomas of the skin are rare. Reported epithelial components include squamous, adnexal, neuroendocrine and basaloid. Including this case, only 47 cases of primary cutaneous basal cell carcinosarcoma have been reported in the literature to date. We performed an extensive immunophenotypic evaluation in our case, which confirmed the previously reported coexpression of p53 in both components, and revealed a hitherto unreported coexpression of p16 and p63. Additionally, this report reviews the clinical, pathologic, immunophenotypic characteristics and outcomes of the basal cell carcinosarcomas reported in the literature, in order to emphasize the overall uniform characteristics and clinical behavior of this neoplasm.     

Squamous cell carcinoma and basal cell carcinoma arising in a naevus sebaceous of Jadassohn: case report and literature review

The development of a basal cell carcinoma within a naevus sebaceous of Jadassohn (NSJ) has commonly been reported. However, the development of a squamous cell carcinoma (SCC) is rare. There have been several reports of SCC arising within a NSJ but many contain little or ambiguous clinical information. A thorough review of the current English language literature has identified only three other well documented cases of SCC arising in a NSJ. Of these only one was a case of simultaneous occurrence of squamous and basal cell carcinoma. We report the second case of both malignancies arising within the same NSJ.     

Metastatic basal cell carcinoma of the posterior neck: case report and review of the literature

Although primary basal cell carcinoma (BCC) represents an extremely common malignancy, metastases derived from BCC are exceedingly rare. The prognosis for metastatic BCC is poor, and little consensus exists regarding predictive factors or optimal treatment strategies. Here, we present the case of a 63-year-old man with BCC of the neck who subsequently developed multiple metastases to subcutaneous tissue, lymph nodes, and the parotid gland. Risk factors and clinical features of metastatic BCC are reviewed, as is the relationship of histopathologic subtype to metastatic behavior. Current chemotherapeutic and targeted therapies also are discussed in the context of recent advances in molecular biology.     

Penile basal cell carcinoma: Report of a case and review of the literature

We describe a 69-year-old man with penile basal cell carcinoma and review the literature on this condition. Basal cell carcinomas of the penis are rare, and there are only 26 other reported cases. There is no documented case of metastatic penile basal cell carcinoma. The one reported case of metastatic penile basal cell carcinoma actually represents urethral transitional cell carcinoma. Therefore conservative therapy with local removal is adequate treatment, and more extensive procedures are unnecessary. Ultraviolet light exposure may be an important etiologic factor for basal cell carcinomas located on sun-exposed areas. The occurrence of basal cell carcinomas on non-sun-exposed areas raises the possibility of other, not yet defined, etiologic agents.     

Multiple skin cysts in nevoid basal cell carcinoma syndrome: a case report and review of the literature

We report a 72-year-old man with nevoid basal cell carcinoma syndrome (NBCCS) who presented with 25 skin cysts on his trunk and extremities. Fourteen of 25 skin cysts (56%) were observed on his hands. Histological examination demonstrated that most of the excised cysts had an epithelial wall with typical epidermal keratinization. However, 4 skin cysts (4/16; 25%) showed a corrugated or festooned inner surface of wall without a granular cell layer, which resembled an odontogenic keratocyst, a characteristic feature of skin cysts in NBCCS. A review of the literature suggested that acral localization of skin cysts is a distinctive feature of NBCCS. In addition, the histological findings of skin cysts resembling an odontogenic keratocyst might be a hallmark of NBCCS.     

Basal cell carcinoma of the umbilicus: a case report and literature review

We report the case of a 43-year-old woman with basal cell carcinoma (BCC) of the umbilicus. Although BCC is a common skin tumor, only 2 cases of BCC arising within the umbilicus have been reported previously. Our review of the literature shows that truncal BCCs frequently develop in younger patients, often grow larger, and are associated with an increased risk for developing multiple nonmelanoma skin cancers. Therefore, we advocate a low threshold for performing biopsies on umbilical lesions that are atypical in appearance, course, or response to therapy.     

硬斑病样基底细胞癌一例

硬斑病样基底细胞癌是基底细胞癌的少见类型,临床上少见,易被忽视而误诊,现报道1例。患者,女,65岁。鼻背丘疹,硬斑10余年,增大伴少量结痂1年。皮肤科检查：鼻背部有一基底约1.5 cm×2 cm、略隆起的局限性浸润性蜡样硬斑块,其上可见条线状凹陷,周围稍红,表面高低不平,可见小片黑痂。组织病理诊断：硬斑病样基底细胞癌。手术切除皮损。