Localized Cutaneous Adverse Event Induced by Anastrozole as Adjuvant Treatment for Breast Cancer: A Case Report.

Cutaneous adverse events caused by aromatase inhibitors have been reported to be rare. We describe a rare case of a cutaneous adverse event that developed in a cancer-affected breast after aromatase inhibitor treatment. A 72-year-old postmenopausal female patient who was diagnosed with stage IA breast cancer received anastrozole as adjuvant treatment. Six months after the initiation of anastrozole, she developed an irregularly shaped purpuric plaque with several purpuric papules surrounding the postoperative scar on her left breast. Histological findings revealed capillary vessel proliferation and expansion, with hemorrhage in the superficial dermis. Immunohistochemistry of the skin biopsy specimen revealed hormone receptor expression limited to the vascular endothelial cells of the proliferating and expanding vessels. We believe that anastrozole induced a change in the local estrogen level, which affected the hormone receptor-positive endothelial cells in the dermis near the primary lesion of the breast cancer and caused a cutaneous adverse event only in the aforementioned area.

Case of semicircular lipoatrophy: relation between its characteristic distribution and anatomical muscle structure.

Semicircular lipoatrophy is characterized by one or more partial, horizontal, band-like depressions, usually on the anterolateral thigh or thighs. We report the case of a 47-year-old woman who presented with a 1-month history of bilateral, parallel, symmetrical depressions on the anterolateral aspects of her thighs. She had been wearing a tight girdle, and the girdle's folds matched the cutaneous bands. Ultrasound examination of the affected areas showed that the muscle tensor fasciae latae became its tendon at this level, and the muscle rectus femoris originated at the same level in the deeper layer. Although semicircular lipoatrophy has a predisposition for the anterolateral aspect of the thigh, and has often been considered to be caused by repetitive mild trauma to the site, we speculate that it is also attributed to the vulnerability of the site, as explained by the muscle structure.

Hybrid schwannoma/perineurioma: a report of two cases including a possible radiation-induced case.

Hybrid schwannoma/perineurioma represents a recently characterized dermal or subdermal tumor showing schwannian cytomorphology and a perineurioma-like architecture composed of an admixture of both cell types. We report two additional cases of hybrid schwannoma/ perineurioma, one of which occurred after irradiation. Patient 1 was that of a 33-year-old man presented with a 2.8-cm dermal tumor on his left lower leg. Patient 2 was that of an 89-year-old woman with a history of uterine carcinoma treated by surgery and radiation therapy at the age of 35. She presented with a 1.2 × 1.0 cm dermal tumor on her left mons pubis with multiple coincidental basal-cell carcinomas around it. Both tumors were microscopically well circumscribed but unencapsulated and situated in the dermis and adipose tissue and showed a vague storiform and lamellar pattern. Cytologically, both tumors contained two-cell populations, i.e. spindled cells with plump nuclei, which were positive for S-100 protein and negative for epithelial membrane antigen (EMA), claudin-1 and CD34, as well as cells with very slender nuclei and elongated cytoplasmic processes, which were negative for S-100 protein yet expressed EMA, claudin-1 and CD34. Claudin-1 was a better marker to highlight cells with very slender nuclei than EMA. Both tumors lacked expression of neurofilament.