Co-occurrence of steatocystoma multiplex, eruptive vellus hair cysts, and trichofolliculomas.

An association between steatocystoma multiplex (SCM) and eruptive vellus hair cysts (EVHCs) has been recognized. Steatocystoma multiplex and EVHC have similar clinical features but distinctive histologic features. Rare cases of co-occurrence of these conditions have been known to occur on the trunk and the forehead. We report a rare case of the simultaneous occurrence of SCM, EVHC, and trichofolliculomas localized to the forehead.

Differential BMI1, TWIST1, SNAI2 mRNA expression pattern correlation with malignancy type in a spectrum of common cutaneous malignancies: basal cell carcinoma, squamous cell carcinoma, and melanoma

Purpose. Melanoma, squamous cell carcinoma (SCC), and basal cell carcinoma (BCC) can be used as a unique model to identify molecular mechanisms to distinguish rarely metastatic (BCC), often metastatic (SCC) and most metastatic (melanoma) cancer. It is known that epithelial-mesenchymal transition and stemness transcription factors (TWIST1, SNAI2/SLUG, and BMI1) play an important role in metastasis and their dysregulation has been demonstrated in metastatic cancers. We hypothesized that this spectrum of cutaneous cancers (BCC, SCC, and melanoma) would be a unique cancer model system to elucidate steps toward cancer invasion and metastasis. Methods. We evaluated the mRNA expression level of BMI1, TWIST1, and SNAI2/SLUG and studied clinicopathological features in 170 skin cancers along with normal tissue samples. Results. We demonstrate downregulation of BMI1 mRNA expression in BCC samples compared with controls (p = 0.0001), SCC (p = 0.001), and melanoma (p = 0.0001) samples. Downregulation of TWIST1 mRNA expression is seen in only BCC samples compared with controls (p = 0.031). High SNAI2 mRNA expression is represented in melanoma samples compared with controls (p = 0.022) and SCC samples (p = 0.031). High mRNA expression of TWIST1 is seen in patients with positive history of cancers. Extremely low mRNA expression of BMI1 is detected in patients with positive history of cancers other than skin cancer. Conclusions. These findings provide support for the hypothesis that the spectrum of cutaneous cancers could be better understood as a series of gene dosage-dependent entities with distinct molecular events. Oncogene-induced senescence, mechanism of which is still unclear, could be one explanation for these results (AU)

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Carcinoma de células basales con fenotipo cilindromatoso / Basal Cell Carcinoma With a Cylindromatous Phenotype

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Estudio descriptivo sobre el carcinoma basocelular en el párpado / Descriptive study on basal cell eyelid carcinoma

OBJETIVO: Describir la presentación y características del carcinoma basocelular en los párpados. MATERIAL Y MÉTODOS: Se realiza un estudio retrospectivo a través de la revisión de historias clínicas, resultados anatomopatológicos y fotografías de 200 pacientes consecutivos con carcinoma basocelular palpebral intervenidos en la clínica oftalmológica Herzog Carl Theodor de Múnich, Alemania, entre los años 2000 y 2013. RESULTADOS: En el presente estudio las mujeres se afectan de forma más frecuente. La edad media son los 70 años. La afectación del párpado inferior se presenta en la mitad de los casos, siendo especialmente frecuente en el tercio central. El 47% de los carcinomas estudiados afectan al margen palpebral. El diámetro promedio es de 9,2 mm. El porcentaje de recidivas tras cirugía con márgenes limpios es del 5%. Estadísticamente se encuentran correlaciones significativas, de tal forma que, a mayor diámetro de la lesión mayor edad del paciente; los tumores aparecen con mayores tamaños a medida que se alejan de la zona medial y se acercan al margen del párpado. CONCLUSIONES: Existe un predominio de afectación en el sexo femenino; esto puede deberse a que la toma de la muestra pertenece a una consulta de cirugía oculoplástica. La aparición del carcinoma aumenta conforme avanza la edad. Existe una menor incidencia de basaliomas en el párpado superior que puede estar relacionada con la protección de la ceja frente a la luz solar. La mayor afectación del párpado inferior puede estar relacionada con un efecto de reflexión de la luz por la córnea hacia dicho párpado. Otra teoría se basa en el daño químico y físico producido por la concentración lagrimal. Los pacientes acuden a consulta de forma más precoz en edades más tempranas, si son mujeres, si se trata de tumores más cercanos a la zona medial y cuando hay mayor lejanía del margen palpebral

OBJECTIVE: To describe a series of cases of basal cell carcinomas of the eyelid. METHODS: A descriptive and retrospective study was conducted by reviewing the medical outcome, histopathological history, and photographic images of 200 patients with basal cell eyelid carcinomas. All were treated in the Herzog Carl Theodor Eye Hospital in Munich, Germany, between 2000 and 2013. RESULTS: In the present study, it was found that females are more affected than males. The mean age of presentation of the tumor occurred at the age of 70 years. In 50% of the cases the tumor was found on the lower lid, especially medially from the center of the lid. The lid margin was involved in 47% of all tumors. The mean diameter was 9.2 mm. The recurrence rate after surgery with histologically clear resection margins was 5%. There was a significant relationship between tumor diameter and age. As tumors where located farther away from medial and closer to the lid margin, they became larger. CONCLUSIONS: There is a predominance of women affected by this tumor. This may be related to the fact that the sample was taken from those attending an oculoplastic surgery clinic, where there are generally more women than men attending. The formation of basal cell carcinomas increases with age. The infrequent involvement of the upper lid could be explained by the protection of the the eyebrow. The frequent involvement of the lower lid may be due to the light reflection (total reflection) by the cornea on the lower lid margin. Also chemical and physical effects of the tears may be more harmful on the lower lid. Patients tend to ask for medical help when they are females, younger, when the tumor is closer to the medial canthus or when the tumor is away from the lid margin

Management of high-risk and advanced basal cell carcinoma

Despite that basal cell carcinoma (BCC) is curative in the vast majority of cases, some patients are at high risk of recurrence and, in a few patients, lesions can progress to a point unsuitable for local therapy and prognosis is quite poor. The aim of the present work is to review clinical and pathologic characteristics as well as classical and new treatment options for high-risk, metastatic and locally advanced BCC. Surgery and radiotherapy remain the selected treatments for the majority of high-risk lesions. However, some patients are located on a blurry clinical boundary between high-risk and locally advanced BCC. Treatment of these patients is challenging and need an individualized and highly specialized approach. The treatment of locally advanced BCC, in which surgery or radiotherapy is unfeasible, inappropriate or contraindicated, and metastatic BCC has changed with new Hedgehog pathway inhibitors of which vismodegib is the first drug approved by FDA and EMA (AU)

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Melanomas y carcinomas basocelulares en un paciente con enfermedad de Parkinson / Melanomas and basal cell carcinomas in a patient with parkinson disease

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Mioepitelioma parotídeo. Estudio citológico, histológico e inmunohistoquímico / Myoepithelioma of the parotid gland: A cytological, histological and inmunohistochemical study

El mioepitelioma de glándula salivar es una neoplasia benigna poco frecuente, que afecta principalmente a la parótida (40 %) y que muestra exclusivamente diferenciación mioepitelial. Histológicamente, exhibe variables patrones arquitecturales y diferentes tipos celulares, que pueden ser dominantes o entremezclarse en diferentes proporciones, lo que condiciona una marcada variabilidad morfológica en el material obtenido por PAAF y con frecuencia su incorrecta interpretación diagnóstica. Aportamos un caso de mioepitelioma parotídeo, diagnosticado inicialmente como maligno en la PAAF, con estudio histológico e inmunohistoquímico

Salivary gland myoepithelioma is a benign rare neoplasm whose main location is the parotid gland (40 %) and displays an exclusive myoepithelial differentation. Histologically it shows several and variable architectural patterns and cellular types that can be dominant or mixed in diverse proportions. This leads to a marked morphological variability in the material obtained by FNAB and not unfrequently to a wrong diagnostic interpretation. We report the case of a parotid lump, initially diagnosed as a malignant neoplasm by FNAB. Later, the tumor ,was correctly diagnosed as myoepithelioma after histological and inmunohistochemical examination

Localized pretibial pemphigoid associated with trichilemmal carcinoma.

We report a case of localized pretibial pemphigoid with concurrent trichilemmal carcinoma of the face in a 93-year-old women. Immunoblot analysis showed circulating autoantibodies against the 230 kDa antigen. After removal of the skin tumor, the bullous skin lesions were reduced and healed with only the topical application of corticosteroid.

Simultaneous occurrence of multiple trichoblastomas and steatocystoma multiplex.

We present a 55-year old man who, since age 21, progressively developed multiple papules and nodules on the face and upper trunk. Light microscopic examination of some of the neoplasms showed trichoblastomas, while others had histopathological features of trichoepithelioma and steatocystoma. Simultaneous occurrence of multiple trichoblastomas/trichoepitheliomas and steatocystomas, not reported previously, could represent multiple neoplasms involving differentiation toward different components of the folliculosebaceous unit.

A Scottish family with Bazex-Dupré-Christol syndrome: follicular atrophoderma, congenital hypotrichosis, and basal cell carcinoma.

Bazex-Dupre-Christol syndrome (BDCS) is an X linked dominant disorder of the hair follicle characterised by follicular atrophoderma, multiple basal cell carcinomas, hypotrichosis, milia, and localised hypohidrosis. Follicular atrophoderma (FA) are follicular funnel shaped depressions, "ice pick marks", seen most commonly on the dorsum of the hands. We describe the first known Scottish family with this syndrome, five affected members spanning three generations. They have hypohidrosis confined to the face, coarse hair, dry skin, milia, and follicular atrophoderma. All the adults have a history of multiple basal cell carcinomas. None of them has any skeletal feature suggestive of Gorlin's syndrome. The clinical features, skin histology, and scanning electron microscopic (SEM) examination of the hair are described and illustrated. The features are compared with 15 previous reports of BDCS and four reports in which this is a possible diagnosis are also reviewed. BDCS should be considered as a differential diagnosis in patients with early onset or familial basal cell carcinomas.

Seborrheic keratosis with trichilemmomas masquerading as melanoma.

Seborrheic keratoses are benign lesions and, generally, are easily diagnosed based on clinical criteria. However, several types of benign as well as malignant lesions have been found associated with seborrheic keratoses, thus confusing the clinical picture. Presented is the first reported case of trichilemmomas occurring within seborrheic keratosis and masquerading as melanoma with regression. Biopsy of unusual seborrheic keratoses is recommended.

Multiple trichoepitheliomas with rare features.

A case of multiple trichoepitheliomas associated with epidermal cysts is reported. The trichoepithelioma lesions were florid and extensive with large nodulo-cystic lesions on the face and a new variant simulating hidradenitis suppurativa near the gluteal cleft.