多发性浅表型基底细胞癌1例

报告1例多发性浅表型基底细胞癌。患者男,52岁,皮疹表现为全身多发黑褐色丘疹、斑块,多处组织病理检查均确诊为基底细胞癌。多发性浅表型基底细胞癌临床表现多样,应注意与其他疾病相鉴别,应加强组织病理、免疫组化等检查,避免误诊。     

多发性基底细胞癌1例并文献复习

报告1例多发性基底细胞癌的临床表现、组织病理并结合相关文献做回顾性分析,探讨多发性基底细胞癌的临床特点及诊治方法。本例患者临床表现为面部多发性黑褐色斑丘疹,且逐渐增多20余年,皮损经组织病理检查确诊为多发性基地细胞癌。多发性基底细胞癌临床较为少见,但不能忽视,一般建议手术切除后送病理检查,并要重视随访。     

家族性多发基底细胞癌

报告1例家族性多发基底细胞癌。患者女,61岁。面部及躯干多发斑丘疹30年余。皮肤科检查:面部及躯干散在数个大小不等的丘疹及斑块。母亲及弟弟有多发性基底细胞癌病史。皮损组织病理:真皮基底样肿瘤细胞团块浸润,周边排列成栅栏状,见收缩间隙;诊断:家族性多发基底细胞癌。     

反射式共聚焦显微镜在多发性基底细胞癌诊断及治疗随访中的应用

目的：观察多发性基底细胞癌反射式共聚焦显微镜（RCM）影像特征,探讨RCM在多发性基底细胞癌诊断及治疗随访中的价值。方法：对在我科就诊的6例疑似多发性基底细胞癌患者64处皮损行RCM检查,62处皮损诊断为基底细胞癌,其中39处行手术切除并行组织病理检查,23处皮损外涂5%咪喹莫特乳膏治疗,治疗后RCM随访。对基底细胞癌的RCM特征进行归纳总结。结果：手术切除行组织病理检查的39处皮损均符合基底细胞癌,与RCM符合率100%,手术切除后3个月、6个月RCM随访,均未发现基底细胞癌RCM特征。外用5%咪喹莫特乳膏的 23处皮损,治疗后3个月、6个月、12个月,分别有12处、8处、4处仍有基底细胞癌RCM特征。 RCM诊断为基底细胞癌的62处皮损特征：异形角质形成细胞96.8%,与表皮相连90.3%,肿瘤细胞巢96.8%,肿瘤巢周围裂隙样暗区54.8%,肿瘤巢周边细胞栅栏状排列51.6%,肿瘤巢内高折光树枝状结构77.4%,肿瘤间质内血管增生扩张充血95.2%,肿瘤巢内及周围高折光颗粒77.4%。结论：基底细胞癌在RCM下有特征性表现,RCM可作为多发性基底细胞癌诊断及治疗随访的有效手段。     

多发性基底细胞癌6例临床与皮肤镜特征分析

目的 探讨多发性基底细胞癌的临床及皮肤镜特征.方法 回顾性分析经皮肤镜诊断且组织病理确诊为多发性基底细胞癌的6例21处皮损其临床及皮肤镜特征.结果 6例多发性基底细胞癌患者的平均年龄54.2岁,平均病程8.25年,男女比例1∶1.21处皮损中临床分型为结节溃疡型9处、色素型7处、浅表型5处.多发性基底细胞癌皮肤镜特征按...     

高频超声弹性成像对基底细胞癌的诊断

目的：探讨高频超声剪切波弹性成像在皮肤基底细胞癌中的应用价值。方法：收集我院2017年3月至2018年12月于本院临床皮肤科因皮肤黑色占位性皮损就诊，同意接受超声检查及手术治疗的患者。结果：共收集患者108例，病理确诊基底细胞癌62例，良性对照病例46例，高频超声弹性成像对基底细胞癌诊断符合率为98.15%。高频超声弹性成像主要表现为基底细胞癌皮损表皮增厚、毛糙或不同程度的表皮缺损改变，可见多发的点状强回声，点状强回声后方无声影，后方有轻微声衰减，内血流信号多少不一，平均杨氏模量为（36.3±8.3）kpa，与周围正常组织弹性应变比约7.4±3.2。结论：高频超声剪切波弹性成像对皮肤基底细胞癌有较高的诊断能力。     

硬斑病样型基底细胞癌2例及其皮肤镜表现

例1女,38岁,因面部皮疹30余年就诊。例2女,70岁,因鼻背皮疹5年,右面部皮疹1年伴糜烂3个月就诊。例1和例2鼻背上皮损均表现为浸润性斑块,皮肤镜检查符合基底细胞癌,皮肤组织病理检查证实为硬斑病样型。例2右面部皮疹经病理证实为结节型基底细胞癌。均采用Mohs显微外科手术治疗。     

41例皮肤基底细胞癌的临床病理及误诊分析

目的：分析总结41例皮肤基底细胞癌的临床病理特点及误诊情况。方法：对41例皮肤基底细胞癌的临床及病理资料进行回顾性分析。结果：41例皮肤基底细胞癌中,发病年龄中位数为59岁（34～82岁）,多发于头面部,共39例,占95．1％,通过组织病理检查,41例均证实为基底细胞癌。其中9例进行免疫组化标记示CK（＋）,S-100（-）。临床诊断为基底细胞癌24例,占58．5％,误诊为脂溢性角化4例,黑素细胞痣3例,鳞状细胞癌、黑素细胞瘤、寻常狼疮各2例,误诊为其他4例。结论：被误诊的皮肤基底细胞癌患者大多数年龄较大,病程缓慢,临床表现不典型。尽早行组织病理检查,并结合免疫组化标记进行识别,可提高皮肤基底细胞癌的诊断准确率。     

痣样基底细胞癌综合征1例及文献复习

报告1例痣样基底细胞癌综合征.患者男,68岁.头部、面部、躯干及双下肢多发米粒至鸽蛋大黑褐色丘疹、结节及斑块7年.皮肤科检查:皮损主要分布于头皮,界限清楚,部分表面破溃;双手掌可见点状凹陷.皮损组织病理检查:表皮部分缺失,棘层轻度增生,真皮可见基底细胞组成的肿瘤细胞团块,肿瘤团块与正常组织间可见裂隙,考虑基底细胞癌.诊...     

21例脂溢性角化病CO2激光治疗后诱发局部溃烂和基底细胞癌

1　病例来源　所有病例均来自皮肤科门诊 ,其中男性 15例 ,女性 6例 ,年龄 5 7～ 74岁 ,平均 6 3岁。因一月至半年前对面颈部脂溢性角化病曾用激光烧灼治疗 ,但伤口一直不愈合而来就诊。2　体检　皮损部位 :额部 4例 ,颞部 3例 ,面颊部 10例 ,颈部 4例。皮损为黄豆至蚕豆大小的糜烂或浅溃疡 ,表面有少许淡黄色浆液性、脓性或血性分泌物。其中 8例皮损基底出现明显变硬 ,浸润。3　组织病理检查　 8例基底变硬浸润皮损作了组织病理检查 ,确诊为基底细胞癌 ,其中 5例为高分化癌 ,3例为低分化癌。4　治疗　 2 1例病人中 ,8例基底细胞癌均作了扩…     

Seborrheic keratosis with compound nevus, junctional nevus and basal cell carcinoma in the same lesion.

Seborrheic keratosis can be associated with different neoplasms such as basal cell carcinomas, squamous cell carcinomas and melanomas. We describe an unusual case of a man who presented with a brown plaque on his back. The clinical diagnosis was melanoma. Histopathologic examination of the lesion revealed four neoplasms: a compound nevus, a junctional nevus, a superficial basal cell carcinoma and a seborrheic keratosis. Although this association most likely represents a chance phenomenon, we discuss the possibility that the seborrheic keratosis developed from the nevus, and that subsequently the junctional nevus and the basal cell carcinoma developed from the seborrheic keratosis.     

Metastatic basal cell carcinoma: a case report and literature review. How accurate is our incidence data?

A 55-year-old man presented to Skin Cancer Surgery Center of Sacramento in 1995 for Mohs micrographic surgery of a 1.5-cm nodular basal cell carcinoma located on the right superior antihelix and scaphoid fossa. The tumor was excised by Mohs micrographic surgery. A recurrent basal cell carcinoma developed at the same site 5 years later and was treated also by Mohs micrographic surgery. One year later (approximately 6 years after the diagnosis of the initial basal cell carcinoma), a right parotid mass was noted on routine physical exam. CT scan and fine needle aspiration of the mass revealed metastatic basal cell carcinoma. The patient underwent excision of the parotid mass followed by radiation therapy. He has done well for the past 2 years since the diagnosis of his metastatic lesion. Basal cell carcinoma is the most common malignancy in the world. The metastatic potential of this tumor has been a cause for concern to many of our patients. We report a case of basal cell carcinoma metastatic to the parotid gland and critically review the incidence data reported in the literature. We recommended the collection of more current and accurate incidence data for basal cell carcinoma and metastatic basal cell carcinoma.     

Renal cell carcinoma with cutaneous metastases

An 86-year-old man presented with multiple papules on his face, neck, lips and ears 4 years after a left nephrectomy for renal cell carcinoma. Shave biopsies and excisions of the cutaneous lesions revealed findings consistent with metastatic renal cell carcinoma of clear cell type. The patient continued to present to the clinic over the next 3 years with similar eruptions, and biopsies continued to confirm renal cell carcinoma. During this time, metastases to the bone, lung, soft palate and posterior leg were also diagnosed. This case represents an unusual clinical presentation of metastatic renal cell carcinoma. It shows that a high index of suspicion should be maintained as cutaneous metastases can mimic other skin conditions.     

Ber-EP4 and MNF-116 in a previously undescribed morphologic pattern of granular basal cell carcinoma.

Granular basal cell carcinoma (GBCC) is a rare subtype of basal cell carcinoma (BCC) with only seven previously described cases in the literature. A 65-year-old man presented with a papule on his cheek that was subsequently removed. Histopathologic examination revealed that the neoplasm had no connection to the overlying epidermis and that the neoplasm had two different morphologies; nodules composed solely of granular cells and other nodules with a rim of basaloid cells and central granular cells. The neoplasm stained for both Ber-EPF4 and MNF-116 thus confirming it as a subtype of BCC. GBCC should be considered in the differential diagnosis of nodular neoplasms containing granular cells.     

EPIDERMODYSPLASIA VERRUCIFORMIS ASSOCIATED WITH MULTIPLE SQUAMOUS CELL CARCINOMAS

In this report a 48 year old patient with non-familial epidermodysplasia verruciformis is described. The disease had persisted for 36 years and had been incorrectly diagnosed as psoriasis on a number of occasions. From 1980 the patient developed numerous skin tumours, including five squamous cell carcinomas (SCCs) and a basal cell carcinoma, on the sun-exposed areas of his body. In June 1986 a poorly-differented SCC, presumed to be a secondary deposit from one of the previously resected skin cancers, was excised from his left parotid gland. A recurrence of this invasive SCC was resected two months later. Despite several courses of radiotherapy and treatment with transfer factor the tumour continued to enlarge, and the patient died from local effects in December 1987. The clinical, virological and immunological criteria used to establish the diagnosis are presented.     

Tumor of the follicular infundibulum with sebaceous differentiation

BACKGROUND: Tumor of the follicular infundibulum (TFI) is a relatively rare tumor which clinically presents as a solitary keratotic papule usually on the head and neck which on microscopic examination typically reveals a plate-like fenestrated epithelial tumor composed of pale staining cells. METHODS: We describe a new variant of TFI. An 80-year-old male with a history of multiple basal cell carcinomas and a squamous cell carcinoma presented with a 2-year history of a red, scaly, slightly elevated plaque on the lateral aspect of his right buttock. RESULTS: Histopathological examination revealed plate-like reticulate epithelial outgrowths of large and pale cells with foci of sebaceous differentiation and numerous colloid bodies. Differential diagnosis included superficial basal cell carcinoma with sebaceous and ductal differentiation, tumor of the follicular infundibulum, an unusual fibroepithelioma of Pinkus or an eccrine fibroadenoma with sebaceous differentiation. CONCLUSION: This case illustrates a hybrid adnexal tumor with histologic features common to both tumor of the follicular infundibulum and superficial epithelioma with sebaceous differentiation.     

Sclerodermiform basal cell carcinoma: how much can we rely on dermatoscopy to differentiate from non-aggressive basal cell carcinomas? Analysis of 1256 cases

Background:The behaviour of each basal cell carcinoma is known to be different according to the histological growth pattern. Among these aggressive lesions, sclerodermiform basal cell carcinomas are the most common type. This is a challenging-to-treat lesion due to its deep tissue invasion, rapid growth, risk of metastasis and overall poor prognosis if not diagnosed in early stages.ObjectiveTo investigate if sclerodermiform basal cell carcinomas are diagnosed later compared to non-sclerodermiform basal cell carcinoma Method: All lesions excised from 2000 to 2010 were included. A pathologist classified the lesions in two cohorts: one with specimens of non-aggressive basal cell carcinoma (superficial, nodular and pigmented), and other with sclerodermiform basal cell carcinoma. For each lesion, we collected patient’s information from digital medical records regarding: gender, age when first attending the clinic and the tumor location.Results:1256 lesions were included, out of which 296 (23.6%) corresponded to sclerodermiform basal cell carcinoma, whereas 960 (76.4%) were non-aggressive subtypes of basal cell carcinoma. The age of diagnosis was: 72.78±12.31 years for sclerodermiform basal cell and 69.26±13.87 years for non-aggressive basal cell carcinoma (P<.0001). Sclerodermiform basal cell carcinomas are diagnosed on average 3.52 years later than non-aggressive basal cell carcinomas. Sclerodermiform basal cell carcinomas were diagnosed 3.40 years and 2.34 years later than non-aggressive basal cell carcinomas in younger and older patients respectively (P=.002 and P=.03, respectively).Study Limitations:retrospective design.Conclusion:The diagnostic accuracy and primary clinic conjecture of sclerodermiform basal cell carcinomas is quite low compared to other forms of basal cell carcinoma such as nodular, superficial and pigmented. The dermoscopic vascular patterns, which is the basis for the diagnosis of non-melanocytic nonpigmented skin tumors, may not be particularly useful in identifying sclerodermiform basal cell carcinomas in early stages. As a distinct entity, sclerodermiform basal cell carcinomas show a lack of early diagnosis compared to less-aggressive subtypes of BCC, and thus, more accurate diagnostic tools apart from dermatoscopy are required to reach the goal of early-stage diagnosis of sclerodermiform basal cell carcinomas.     

Occult Basal Cell Carcinoma Arising in Seborrheic Keratosis

The present study reports a case of an occult basal cell carcinoma that arose in seborrheic keratosis. The patient was a fifty-six-year-old male who presented with a dark brown plaque on his back. Clinically, the lesion demonstrated no nodules or ulcerations suggesting that it was malignant. However, histopathological analysis of the lesion revealed an atypical basaloid cell mass that appeared to be a solid basal cell carcinoma beneath and surrounded by a seborrheic keratosis lesion. Thus, the coexistence of basal cell carcinoma and seborrheic keratosis is possible and should be considered when a malignant change in seborrheic keratosis is apparent.     

Acrochordons as a presenting sign of nevoid basal cell carcinoma syndrome

BACKGROUND: Nevoid basal cell carcinoma syndrome (NBCCS) is a genodermatosis with autosomal dominant inheritance. In identified kindreds the diagnosis is relatively easy, but for the patients without family history of this syndrome a high clinical suspicion is necessary for diagnosis. OBJECTIVE: Acrochordons are distinctly uncommon in childhood. Our purpose was to evaluate skin tags that develop at an early age. METHODS: This is a retrospective series evaluation of 7 children who presented with pedunculated papules (acrochordon-like growths). A full history was then correlated with biopsy results in each patient. RESULTS: Clinically, lesions consisted of flesh-colored and pigmented pedunculated papules. Histopathologic examination of these papules showed basal cell carcinomas in each biopsy specimen. CONCLUSION: We consider that "skin tag"-like basal cell carcinomas in childhood may represent a marker for NBCCS. Early diagnosis of this syndrome and early sun protection of the affected children could help decrease the number of lifetime tumors. Biopsy should be performed on acrochordons in children because they may be the presenting sign of NBCCS. Because these tags may precede other stigmata of the NBCCS, recognition may facilitate early diagnosis and allow early treatment and sun protection.