RESUMEN
BACKGROUND: Dermoscopy is a useful, noninvasive technique also used to assess sebaceous lesions in humans. Sebaceous hyperplasia, sebaceous adenoma and sebaceous epithelioma are common cutaneous lesions in dogs; however, their dermoscopic features have not been investigated. HYPOTHESIS/OBJECTIVES: The objectives of this study are to describe the dermoscopic features of canine sebaceous lesions and to assess the interobserver agreement on dermoscopic parameters. ANIMALS: Thirty-four lesions excised from 17 client-owned dogs, histologically confirmed as sebaceous proliferations, were included in this study. MATERIALS AND METHODS: Sebaceous lesions were evaluated in vivo at ×10 magnification with a handheld dermoscope. Each dermoscopic image was assessed independently by two ECVD board-certified veterinary referral clinicians and an ECVD resident. RESULTS: Thirty sebaceous hyperplasias, two sebaceous adenomas and two sebaceous epitheliomas were included. Dermoscopically, most lesions (91%) had single or multiple, well-defined, white-yellowish structures composed of grouped ovoid areas (clods). Irregular linear and, less commonly, arborising vessels were detected at the periphery of the yellow lobular-like structures in 93% of sebaceous hyperplasias and in 50% of neoplastic lesions. Erosions were seen in 6% of sebaceous hyperplasias and 50% of neoplastic lesions. Good interobserver agreement was found for white/yellowish clods (k = 0.75), yellow scales (k = 0.83), brown/grey dots (k = 0.80), erosions (k = 0.82) and red/brownish scales/crusts (k = 0.75). There was moderate agreement for fissures (k = 0.48) and vascular pattern (k = 0.51-0.53). CONCLUSIONS AND CLINICAL RELEVANCE: Dermoscopy represents a useful technique to assess sebaceous gland proliferations in dogs, as it is in humans.
Asunto(s)
Enfermedades de los Perros , Neoplasias de las Glándulas Sebáceas , Neoplasias Cutáneas , Humanos , Perros , Animales , Variaciones Dependientes del Observador , Hiperplasia/veterinaria , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/veterinaria , Neoplasias de las Glándulas Sebáceas/diagnóstico por imagen , Neoplasias de las Glándulas Sebáceas/veterinaria , Dermoscopía/veterinaria , Enfermedades de los Perros/diagnóstico por imagenRESUMEN
Sebaceous carcinoma of the breast is an extremely rare tumor. To the best of our knowledge only 15 cases have been reported in literature. Herein, we report a case of sebaceous carcinoma of the breast and describe the histopathologic features of sebaceous carcinoma of the breast in an elderly female.
Asunto(s)
Adenocarcinoma Sebáceo , Neoplasias de la Mama , Neoplasias de las Glándulas Sebáceas , Adenocarcinoma Sebáceo/diagnóstico por imagen , Adenocarcinoma Sebáceo/cirugía , Anciano , Neoplasias de la Mama/diagnóstico por imagen , Femenino , Humanos , Neoplasias de las Glándulas Sebáceas/diagnóstico por imagen , Neoplasias de las Glándulas Sebáceas/cirugíaRESUMEN
Sebaceous cell carcinoma is well known as the "great masquerader" mimicking other benign or malignant eyelid conditions and lesions. We present a case of a middle age male presenting with a subacute left upper lid abscess who was ultimately diagnosed with malignant sebaceous cell carcinoma after incision and drainage and treatment with broad spectrum antibiotics. This case highlights the deceptive clinical and radiographic appearance of this tumor and the importance of histologic examination in atypical or refractory periorbital abscesses.
Asunto(s)
Absceso/terapia , Adenocarcinoma Sebáceo/terapia , Enfermedades de los Párpados/terapia , Neoplasias de los Párpados/terapia , Neoplasias de las Glándulas Sebáceas/terapia , Absceso/diagnóstico por imagen , Adenocarcinoma Sebáceo/diagnóstico por imagen , Antibacterianos/uso terapéutico , Terapia Combinada , Medios de Contraste , Diagnóstico Diferencial , Drenaje , Enfermedades de los Párpados/diagnóstico por imagen , Neoplasias de los Párpados/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de las Glándulas Sebáceas/diagnóstico por imagenRESUMEN
Sebaceous carcinoma is a rare cutaneous malignancy that frequently mimics other dermatologic conditions. Extraocular subtypes are uncommon, but when present are frequently located in the head and neck region. Herein, we present a patient with a rapidly growing upper back mass eventually diagnosed as sebaceous carcinoma and managed with wide surgical excision. Currently, sparse literature exists to guide management of such patients. This case highlights not only the diagnostic challenges of sebaceous carcinoma, but also the need for further studies to investigate therapeutic interventions and long-term outcomes.
Asunto(s)
Adenocarcinoma Sebáceo/patología , Neoplasias de las Glándulas Sebáceas/patología , Adenocarcinoma Sebáceo/diagnóstico , Adenocarcinoma Sebáceo/diagnóstico por imagen , Anciano , Dorso , Diagnóstico Diferencial , Humanos , Imagen por Resonancia Magnética , Masculino , Neoplasias de las Glándulas Sebáceas/diagnóstico , Neoplasias de las Glándulas Sebáceas/diagnóstico por imagen , Enfermedades de la Piel/diagnósticoAsunto(s)
Adenocarcinoma Sebáceo , Neoplasias de los Párpados , Neoplasias de las Glándulas Sebáceas , Humanos , Adenocarcinoma Sebáceo/diagnóstico por imagen , Adenocarcinoma Sebáceo/patología , Neoplasias de los Párpados/diagnóstico por imagen , Neoplasias de los Párpados/patología , Párpados , Neoplasias de las Glándulas Sebáceas/diagnóstico por imagen , Neoplasias de las Glándulas Sebáceas/patología , Estudios RetrospectivosRESUMEN
BACKGROUND: Extraocular sebaceous carcinoma (SC) is a rare malignancy with metastatic potential. The authors present a case of a rapidly growing extraocular SC with equivocal radiographic imaging to highlight challenges in tumor management. OBJECTIVE: To examine the existing literature for evaluation and management recommendations of extraocular SC. METHODS AND MATERIALS: A comprehensive review of relevant English articles in PubMed through May 2015. RESULTS: Tumor-specific staging system and management guidelines do not currently exist for extraocular SC. Mohs micrographic surgery or wide local excision are the most commonly used surgical treatments. Regional/distant metastasis occurs infrequently, but systemic workup with radiographic imaging or sentinel lymph node biopsy may be warranted in select cases. Adjuvant radiation therapy can be considered for recurrent and metastatic tumors. CONCLUSION: Extraocular SCs present unique challenges that may benefit from multidisciplinary management. Surgical removal with negative pathologic margins is the mainstay treatment of extraocular SC. Additional studies will help clarify the optimal diagnostic workup and adjuvant treatment of patients.
Asunto(s)
Adenocarcinoma Sebáceo/cirugía , Neoplasias de las Glándulas Sebáceas/cirugía , Adenocarcinoma Sebáceo/diagnóstico por imagen , Adenocarcinoma Sebáceo/patología , Femenino , Humanos , Metástasis Linfática , Persona de Mediana Edad , Cirugía de Mohs , Síndrome de Muir-Torre/patología , Estadificación de Neoplasias , Neoplasias Primarias Múltiples/patología , Pronóstico , Radiografía , Radioterapia Adyuvante , Neoplasias de las Glándulas Sebáceas/diagnóstico por imagen , Neoplasias de las Glándulas Sebáceas/patología , Biopsia del Ganglio Linfático CentinelaRESUMEN
Cerebriform sebaceous naevus (CSN) is a rare morphological sebaceous naevus variant and challenging to diagnose prenatally due to its flat, smooth and waxy appearance and lack of association with extracutaneous manifestations.A multigravida was referred to our tertiary obstetric unit at 24 weeks of gestation for evaluation of fetal auricular lesions. We were able to further characterise the lesions via serial obstetric ultrasound imaging with the aid of three-dimensional (3D) technology. Although the precise diagnosis prenatally was uncertain, the use of 3D technology allowed the reconstruction of the fetal cutaneous lesions for multidisciplinary assessment to facilitate the development of a neonatal management plan. The diagnosis of CSN was made postnatally on biopsy.
Asunto(s)
Ultrasonografía Prenatal , Humanos , Femenino , Embarazo , Adulto , Nevo Sebáceo de Jadassohn/patología , Nevo Sebáceo de Jadassohn/diagnóstico , Nevo Sebáceo de Jadassohn/diagnóstico por imagen , Recién Nacido , Nevo/diagnóstico por imagen , Nevo/patología , Nevo/diagnóstico , Imagenología Tridimensional , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/diagnóstico por imagen , Neoplasias Cutáneas/diagnóstico , Neoplasias de las Glándulas Sebáceas/patología , Neoplasias de las Glándulas Sebáceas/diagnóstico , Neoplasias de las Glándulas Sebáceas/diagnóstico por imagenAsunto(s)
Adenocarcinoma Sebáceo/patología , Neoplasias de la Mama/patología , Neoplasias de las Glándulas Sebáceas/patología , Adenocarcinoma Sebáceo/diagnóstico por imagen , Anciano , Neoplasias de la Mama/diagnóstico por imagen , Femenino , Humanos , Imagen por Resonancia Magnética , Neoplasias de las Glándulas Sebáceas/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Ultrasonografía MamariaRESUMEN
Sebaceous carcinoma is a rare cutaneous malignancy that is most frequently found in the eyelids with an estimated risk of regional lymph node metastasis in the 8% to 14% range. The authors have previously reported the use of sentinel lymph node biopsy and microscopically positive sentinel lymph nodes in various eyelid and conjunctival cancers, including conjunctival and eyelid melanoma and Merkel cell carcinoma. The authors herein describe the first successful identification of a microscopically positive sentinel lymph node in a patient with sebaceous carcinoma of the eyelid, suggesting that sentinel lymph node biopsy for sebaceous carcinoma of the eyelid deserves further investigation.
Asunto(s)
Adenocarcinoma Sebáceo/secundario , Neoplasias de los Párpados/patología , Neoplasias de las Glándulas Sebáceas/patología , Adenocarcinoma Sebáceo/diagnóstico por imagen , Anciano , Neoplasias de los Párpados/diagnóstico por imagen , Femenino , Humanos , Ganglios Linfáticos/patología , Metástasis Linfática , Cintigrafía , Radiofármacos , Neoplasias de las Glándulas Sebáceas/diagnóstico por imagen , Biopsia del Ganglio Linfático Centinela , Azufre Coloidal Tecnecio Tc 99m , Tomografía Computarizada por Rayos XRESUMEN
A 76-year-old man presented atypically with a 4-week history of a rapidly enlarging ulcerated nodular lesion of the left upper eyelid that was found to be sebaceous cell carcinoma. Further investigation showed no metastatic disease, and Mohs surgery was performed to resect the tumor. Histopathologic analysis showed features diagnostic of sebaceous cell carcinoma. However, most of the mass consisted of xanthomatous granulomatous inflammatory reaction vastly out of proportion with the tumor burden. The patient was spared from orbital exenteration, and no evidence of recurrence was present 6 months after resection.
Asunto(s)
Adenocarcinoma Sebáceo/patología , Neoplasias de los Párpados/patología , Granuloma/patología , Neoplasias de las Glándulas Sebáceas/patología , Xantomatosis/patología , Adenocarcinoma Sebáceo/diagnóstico por imagen , Adenocarcinoma Sebáceo/cirugía , Anciano , Neoplasias de los Párpados/diagnóstico por imagen , Neoplasias de los Párpados/cirugía , Granuloma/diagnóstico por imagen , Granuloma/cirugía , Humanos , Masculino , Cirugía de Mohs , Tomografía de Emisión de Positrones , Neoplasias de las Glándulas Sebáceas/diagnóstico por imagen , Neoplasias de las Glándulas Sebáceas/cirugía , Tomografía Computarizada por Rayos X , Xantomatosis/diagnóstico por imagen , Xantomatosis/cirugíaRESUMEN
Sebaceous carcinoma is a rare malignant skin neoplasm arising from sebaceous glands. Its clinical diagnosis is difficult and reports of dermoscopic findings have been limited. This study aims to analyze its dermoscopic features and differential diagnosis in dermoscopic examination. The study included patients diagnosed with histologically proven sebaceous carcinomas as well as diagnosed cases of sebaceous hyperplasia, sebaceoma, squamous cell carcinoma and basal cell carcinoma for comparison of dermoscopic findings. The dermoscopic criterion of presence of sebaceous carcinoma was scored only if the two evaluators reached a consensus. Fifteen cases of histologically diagnosed sebaceous carcinoma were included in our study. All cases were extraocular sebaceous carcinoma. A total of 60 (15 basal cell carcinomas, 15 squamous cell carcinomas, 15 sebaceous hyperplasias and 15 sebaceomas) cases were collected for comparing dermoscopic features with sebaceous carcinoma. In dermoscopic analysis of sebaceous carcinoma, the majority of tumors (66.67%) presented polymorphic vessel pattern. Other features included whitish-pink areas (80%), yellowish structures (73.33%) and yellowish structureless areas (60%). Yellowish structures in sebaceous carcinomas are the main dermoscopic findings to differentiate squamous cell and basal cell carcinomas (P < 0.001), whereas purplish globules, shiny white blotches and strands and whitish-pink area distinguish sebaceous carcinomas from other sebaceous tumors (P < 0.05).
Asunto(s)
Adenocarcinoma Sebáceo , Carcinoma Basocelular , Neoplasias de las Glándulas Sebáceas , Neoplasias Cutáneas , Adenocarcinoma Sebáceo/diagnóstico por imagen , Carcinoma Basocelular/diagnóstico por imagen , Dermoscopía , Diagnóstico Diferencial , Humanos , Neoplasias de las Glándulas Sebáceas/diagnóstico por imagen , Neoplasias Cutáneas/diagnóstico por imagenRESUMEN
PURPOSE: To determine the practice patterns of ophthalmic plastic surgeons regarding the management of eyelid sebaceous carcinoma (SC). METHODS: An electronic survey was distributed to oculoplastic surgical colleagues in the Asia Pacific region requesting clinical information and treatment approaches to SC. RESULTS: The responses from 192 respondents from the Asia Pacific region was included and analyzed in this study. For initial diagnosis, most surgeons selected incisional biopsy (55%), followed by complete excision (35%). Initial workup was mainly by palpation of lymph nodes, chest X-ray, and computerized tomography scan (CT-scan) of the orbit. Conjunctival map biopsy was done in selected cases. Sentinel lymph node biopsy (SLNB) was done mainly for tumors larger than 10 mm. Management was mainly by surgical excision (5 mm margin) combined with adjuvant therapy in some cases, with radiotherapy being the most common. Margin status was determined most frequently by frozen section as evaluated by the pathologist (57%) followed by Mohs micrographic surgery (18%). Surveillance was based mainly on physical examination alone. CONCLUSION: The Asia Pacific oculoplastic surgeons prefer incisional biopsy for lesions suspicious of SC prior to definitive surgery. This is in contrast to survey results previously reported in other populations. Frozen section control (done by an oculoplastic surgeon with pathology support) is most commonly used for margin control and conjunctival map biopsies are done only in selected cases. Despite the potential benefits of SLNB, access and expertise in this area is currently lacking in the Asia Pacific region.
Asunto(s)
Adenocarcinoma Sebáceo/cirugía , Neoplasias de los Párpados/cirugía , Pautas de la Práctica en Medicina/estadística & datos numéricos , Neoplasias de las Glándulas Sebáceas/cirugía , Adenocarcinoma Sebáceo/diagnóstico por imagen , Adenocarcinoma Sebáceo/patología , Anciano , Asia/epidemiología , Terapia Combinada , Neoplasias de los Párpados/diagnóstico por imagen , Neoplasias de los Párpados/patología , Femenino , Encuestas de Atención de la Salud , Humanos , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Oftalmológicos , Océano Pacífico , Radioterapia , Neoplasias de las Glándulas Sebáceas/diagnóstico por imagen , Neoplasias de las Glándulas Sebáceas/patología , Biopsia del Ganglio Linfático Centinela , Encuestas y Cuestionarios , Tomografía Computarizada por Rayos XRESUMEN
We examined dermoscopic features of three cases of extraocular sebaceous carcinoma and reviewed the literatures. The yellowish structures, polymorphous vessels and ulceration were common findings in our cases and all cases of the previous reports. The appearance of whitish-pink areas has not been described previously. Our results suggested that the combination of four dermoscopic features, whitish-pink areas, yellowish structures, polymorphous vessels and ulceration might be distinctive in extraocular sebaceous carcinoma.
Asunto(s)
Adenocarcinoma Sebáceo/patología , Dermoscopía , Neoplasias de las Glándulas Sebáceas/patología , Adenocarcinoma Sebáceo/diagnóstico por imagen , Anciano , Anciano de 80 o más Años , Antígenos CD34/análisis , Dorso , Cejas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mucina-1/análisis , Nariz , Estudios Retrospectivos , Neoplasias de las Glándulas Sebáceas/diagnóstico por imagen , Piel/diagnóstico por imagen , Piel/patologíaRESUMEN
BACKGROUND: Sebaceous carcinoma is an aggressive adnexal skin tumor with a predilection for the eyelids and sebaceous glands of the head and neck. CASE PRESENTATION: A 73 year-old man presented with confusion and was found to have widely disseminated sebaceous carcinoma with metastases to brain, lungs, liver, bowel, lymph nodes, and bone. Following initial treatment of the brain metastases with surgery he received post-operative radiosurgery. He then began systemic immunotherapy with pembrolizumab. After 6 months, he developed a near complete response to therapy by irRECIST and RECIST v.1.1. The response was associated with circulating CD8+ T cells with central memory (CM) and effector memory (EM) phenotype and mature CD16 + CD57+ NK cells. During treatment the patient developed adrenal insufficiency requiring high-dose systemic corticosteroids and later adrenal replacement therapy. After 12-months of follow-up he showed imaging evidence of progression in liver, mediastinum, and abdominal lymph nodes. Given persistent, strong PD-L1 expression he resumed pembrolizumab therapy and showed radiographic evidence of an ongoing response to therapy. CONCLUSIONS: This is the first report describing objective clinical and radiographic responses following immunotherapy for widely metastatic sebaceous carcinoma. The dramatic therapeutic response to pembrolizumab was associated with peripheral blood circulating memory T cells and mature Natural Killer cells after 6 months (24 weeks) of therapy. This report supports prospective clinical trials of anti-PD1 checkpoint blockade for metastatic sebaceous carcinoma.
Asunto(s)
Anticuerpos Monoclonales Humanizados/uso terapéutico , Antineoplásicos Inmunológicos/uso terapéutico , Receptor de Muerte Celular Programada 1/antagonistas & inhibidores , Neoplasias de las Glándulas Sebáceas/tratamiento farmacológico , Anciano , Humanos , Masculino , Repeticiones de Microsatélite , Tomografía Computarizada por Tomografía de Emisión de Positrones , Neoplasias de las Glándulas Sebáceas/diagnóstico por imagen , Neoplasias de las Glándulas Sebáceas/genética , Neoplasias de las Glándulas Sebáceas/patología , Análisis de Secuencia de ADN , Resultado del TratamientoRESUMEN
Cutaneous adnexal tumors include lesions with apocrine, eccrine, follicular, sebaceous, and mixed differentiation. Most are benign and sporadic, although malignant forms are occasionally observed and some cases develop in the setting of inherited syndromes. These tumors often cause immense diagnostic difficulty. Dermoscopy is a noninvasive technique that has greatly improved the diagnostic accuracy of different skin lesions, including these tumors. We provide a review of the literature on the dermoscopic structures and patterns associated with adnexal tumors. Most patterns associated with this kind of tumor are nonspecific and are observed in other nonadnexal tumors, especially in basal cell carcinomas.
Asunto(s)
Adenoma/diagnóstico por imagen , Carcinoma/diagnóstico por imagen , Dermoscopía , Enfermedades del Cabello/diagnóstico por imagen , Nevo Sebáceo de Jadassohn/diagnóstico por imagen , Neoplasias de las Glándulas Sebáceas/diagnóstico por imagen , Glándulas Sebáceas/patología , Neoplasias de las Glándulas Sudoríparas/diagnóstico por imagen , Acrospiroma/diagnóstico por imagen , Síndrome de Birt-Hogg-Dubé/diagnóstico por imagen , Carcinoma Adenoide Quístico/diagnóstico por imagen , Quiste Folicular/diagnóstico por imagen , Hidrocistoma/diagnóstico por imagen , Humanos , Hiperplasia/diagnóstico por imagen , Neoplasias Basocelulares/diagnóstico por imagen , Síndromes Neoplásicos Hereditarios/diagnóstico por imagen , Pilomatrixoma/diagnóstico por imagen , Poroma/diagnóstico por imagen , Neoplasias Cutáneas/diagnóstico por imagen , Siringoma/diagnóstico por imagen , Adenomas Tubulares de las Glándulas Sudoríparas/diagnóstico por imagenRESUMEN
RATIONALE: Though giant malignant tumors arising in the eyelid are rare, they often require extensive surgery for removal along with orbital exenteration. Because of this, repairing orbital defects is an important factor in the surgical strategy. PATIENT CONCERNS: Case 1 was a 78-year-old nomad man who presented in the Department of Ophthalmology with a giant tumor in his right eyelid, which had developed over three years. Clinical examination revealed a huge pigmented, nonhealing ulcerated lesion, approximately 52×44×40âmm in size. Case 2 was a 52-year old rural male complaining of a huge tumor in the right eyelid. Patient medical history revealed that the mass was initially the size of a soybean and gradually grew over 3 years to the size of a fist. DIAGNOSES: Histopathological examination of the tumors revealed that one was a basal cell carcinoma and the other a sebaceous gland carcinoma. INTERVENTIONS: The two cases of giant malignant eyelid tumors were surgically excised using rapid frozen section margin control. Different pedicle myocutaneous flaps were used to repair the orbital skin defects. OUTCOMES: Postoperative follow-up showed perfect healing of the pedicle flaps and good patient compliance. The results of these cases indicate that covering exposed orbital cavities with composite pedicle mycuaneous flaps is a simple and practical strategy for orbital reconstruction. Not only does this help maintain orbital stability, but it also provides opportunities for patients to return to normal lives. LESSONS: Although surgical management is often the first option for treatment of giant eyelid tumors, recurrence and mortality due to the tumors is still high after long-term follow-up. Therefore, early discovery and treatment is the best way to control the progression of giant eyelid tumors and enhance survivability.
Asunto(s)
Carcinoma Basocelular/cirugía , Neoplasias de los Párpados/cirugía , Párpados/cirugía , Neoplasias de las Glándulas Sebáceas/cirugía , Neoplasias Cutáneas/cirugía , Colgajos Quirúrgicos , Anciano , Carcinoma Basocelular/diagnóstico por imagen , Carcinoma Basocelular/patología , Neoplasias de los Párpados/diagnóstico por imagen , Neoplasias de los Párpados/patología , Párpados/diagnóstico por imagen , Párpados/patología , Humanos , Masculino , Persona de Mediana Edad , Procedimientos de Cirugía Plástica , Neoplasias de las Glándulas Sebáceas/diagnóstico por imagen , Neoplasias de las Glándulas Sebáceas/patología , Neoplasias Cutáneas/diagnóstico por imagen , Neoplasias Cutáneas/patologíaRESUMEN
Solitary pink lesions can pose a particular challenge to dermatologists because they may be almost or completely featureless clinically and dermoscopically, previously requiring biopsy to exclude malignancy. However, these lesions usually are not particularly challenging histopathologically. Thus, the incorporation of in vivo reflectance confocal microscopy into the clinical practice, which allows for noninvasive examination of the skin at the cellular level revealing features previously seen only on histopathology, is particularly useful for this subset of clinically difficult lesions.
Asunto(s)
Acantoma/diagnóstico por imagen , Adenoma/diagnóstico por imagen , Carcinoma/diagnóstico por imagen , Hemangioma/diagnóstico por imagen , Histiocitoma Fibroso Benigno/diagnóstico por imagen , Melanoma Amelanótico/diagnóstico por imagen , Neoplasias de las Glándulas Sebáceas/diagnóstico por imagen , Neoplasias Cutáneas/diagnóstico por imagen , Enfermedad de Bowen/diagnóstico por imagen , Neoplasias de la Mama/diagnóstico por imagen , Carcinoma in Situ/diagnóstico por imagen , Carcinoma de Células Escamosas/diagnóstico por imagen , Dermoscopía , Granuloma Piogénico/diagnóstico por imagen , Humanos , Microscopía Intravital , Queratosis Actínica/diagnóstico por imagen , Queratosis Seborreica/diagnóstico por imagen , Microscopía Confocal , Enfermedad de Paget Extramamaria/diagnóstico por imagen , Enfermedad de Paget Mamaria/diagnóstico por imagen , Enfermedades de la Piel/diagnóstico por imagenRESUMEN
A 53-year-old woman had had a pale-brown lesion on her right cheek and neck from birth. Since she was about 40 years old, part of the lesion had gradually elevated and increased in size. At the first examination, there was a huge mass measuring 110 x 70 x 35 mm on the right cheek. A wide local excision of the area including a superficial parotidectomy and submandibular lymph node dissection was performed, followed by full thickness skin grafting. Histological examination of the tumor revealed an invasive dermal neoplasm characterized by lobes that were composed of foamy cells stained with Sudan-IV mixed with many atypical cells showing remarkable variation in the shapes and sizes of their nuclei. The surrounding epithelial changes were consistent with nevus sebaceus. From these findings, the gigantic tumor was diagnosed as a sebaceous carcinoma arising in nevus sebaceus.
Asunto(s)
Adenocarcinoma Sebáceo/diagnóstico , Nevo/diagnóstico , Neoplasias de las Glándulas Sebáceas/diagnóstico , Neoplasias Cutáneas/diagnóstico , Adenocarcinoma Sebáceo/diagnóstico por imagen , Adenocarcinoma Sebáceo/patología , Adenocarcinoma Sebáceo/cirugía , Mejilla , Diagnóstico Diferencial , Femenino , Humanos , Persona de Mediana Edad , Neoplasias Primarias Múltiples , Nevo/congénito , Nevo/patología , Nevo/cirugía , Cintigrafía , Neoplasias de las Glándulas Sebáceas/diagnóstico por imagen , Neoplasias de las Glándulas Sebáceas/patología , Neoplasias de las Glándulas Sebáceas/cirugía , Neoplasias Cutáneas/congénito , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/cirugíaRESUMEN
The association between vitamin-D-resistant rickets and linear sebaceous naevus syndrome is extremely rare. Only eight cases have been described in the English literature and in none were the skeletal aspects addressed. We present three new cases and describe the musculoskeletal features. The details and outcome of surgery for correction of the deformities are discussed. The disturbances of metabolism of vitamin D and the effects of pharmacological treatment are also described.