scispace - formally typeset

Journal ArticleDOI

Melanoma in-situ arising in seborrheic keratosis: a case report

23 Oct 2008-Cases Journal (BioMed Central)-Vol. 1, Iss: 1, pp 263-263

TL;DR: It is not uncommon for many physicians to remove a typical seborrheic keratosis without a confirmatory microscopic confirmation, so it is urged that all such lesions be examined by the pathologist to avoid missing another concomitant malignant lesion such as melanoma which needs adequate resection and close follow-up.

AbstractBackground Seborrheic keratosis is a very common benign skin tumor in man. Melanoma is rare but is the most dreaded of all malignant skin tumors. A melanoma arising in a seborrheic keratosis is distinctly rare. We are reporting such a case occurring in an 86-year-old man.

Topics: Seborrheic keratosis (74%), Melanoma (52%)

...read more

Content maybe subject to copyright    Report

Citations
More filters

Journal ArticleDOI
TL;DR: Otolaryngologists should consider a complete removal and histological examination of seborrheic keratoses, which are benign skin tumors; however, the lesions can recur after removal.
Abstract: The pathogenesis of a seborrheic keratosis has not been fully elucidated. In the present study, we reviewed the literature to increase the awareness of this disease among otolaryngologists and to stress the need for prompt diagnosis and treatment. This was a retrospective study in seven patients presenting with seborrheic keratoses in the ear. We included only those patients in whom keratoses were confirmed by pathology after a complete excision. In six patients, seborrheic keratoses were observed in the external auditory canal, and in one patient, they were observed in the auricle. The subtype of keratoses was classified as acanthotic in six patients; one patient had an unclassified type associated with basal cell carcinoma. Seborrheic keratoses are benign skin tumors; however, the lesions can recur after removal. Moreover, an association between seborrheic keratoses and malignant skin tumors has been reported. Therefore, otolaryngologists should consider a complete removal and histological examination of seborrheic keratoses.

13 citations


Journal ArticleDOI
TL;DR: High-frequency ultrasonographic examination is a non-invasive, easy and inexpensive screening method for the determination of different skin cancers as it provides valuable information allowing to determine the cutting margins and lesion shape.
Abstract: Introduction Ultrasonographic examination is commonly used in an outpatient setting, possibly due to its low cost, low risk for patients and the possibility to obtain real time images. Typically used heads have the frequency ranging from 7.5 to 12 MHz. Higher frequencies ensure higher resolution, yet they are limited by the penetration depth - reaching from several to several tens of millimetres into the skin. High-frequency ultrasonography (HFUS) appears to be a promising method for the detection and differential diagnostics of selected nodular skin lesions. Aim The study aimed at a comparison of the data obtained by using HFUS, histopathological and dermatoscopic images of selected skin lesions to determine their common features. Material and methods Nodular lesions classified as potentially malignant were subjected to clinical, dermatoscopic and high-frequency ultrasonographic examinations. Then the patients were referred for surgical removal with histopathological assessment. Results A total of 54 nodular lesions were examined, out of which 34 were diagnosed as non-melanoma. The most common lesions were melanocytic naevi dermatofibroma, nodular basal cell carcinoma and pyogenic granuloma. Other examined lesions included blue naevus, seborrheic wart, xanthogranuloma juvenile and Spits naevus. In all lesions except Spitz naevus, HFUS images corresponded at least with dermatoscopic or histopathology images. Conclusions HFUS can be used as a supporting diagnostic tool ensuring better pre-operative proceedings. HFUS is a non-invasive, easy and inexpensive screening method for the determination of different skin cancers as it provides valuable information allowing to determine the cutting margins and lesion shape.

5 citations



Journal ArticleDOI
TL;DR: Comparative immunohistochemical studies of expression of cyclin-dependent kinase 2 in 16 benign epithelial skin lesions, 11 precancerous lesions, 19 cases of basal cell carcinoma, 14 squamous cell carcinomas (SCCs), and 7 fibromas found increase of the CDK-2 level was observed in precancerously lesions, and the expression was strongest in SCCs.
Abstract: Lesions originating from different types of skin cells differ significantly with respect to their pathologic importance. The aim of this work was to examine as to what extent the differences in the origin are reflected in expression levels of CDK-2 and to investigate whether CDK-2 expression might be considered as potential marker useful for diagnostics and assessment of invasiveness of human nonmelanocytic lesions. We conducted comparative immunohistochemical studies of expression of cyclin-dependent kinase 2 (CDK-2) in 16 benign epithelial skin lesions, 11 precancerous lesions, 19 cases of basal cell carcinoma (first such study), 14 squamous cell carcinomas (SCCs), and 7 fibromas. Development of benign epithelial skin lesions was not associated with considerable increase of the CDK-2 expression. Increase of the CDK-2 level was observed in precancerous lesions, and the expression was strongest in SCCs. The level of CDK-2 may be related to invasiveness of skin cancers, as squamous cell carcinomas expressed the enzyme significantly stronger than basal cell carcinomas. Higher percentage fraction of CDK-2 positive cells observed in SCC compared with precancerous lesions may be useful for histopathologic diagnostics of this cancer. Moreover, strong immunohistochemical CDK-2 staining of the cancer cells present deep in dermis may facilitate their detection in histopathologic examinations.

2 citations


Journal ArticleDOI
Abstract: This article summarizes the main epidemiologic and diagnostic features of seborrheic keratosis-like (SK-like) melanoma. We performed a review of the current literature. The real and current incidence and prevalence of SK-like melanoma are unknown. Many lesions are misdiagnosed and not excised with histopathologic confirmation, or excised without an appropriate surgical approach due to a benign clinical and dermoscopic appearance. SK-like melanoma presents both melanoma and SK features. SK-like melanoma and SK are often clinically indistinguishable even for experienced dermatologists. Clinically, it develops as a black-dark brown or light slightly elevated, papule, nodule or plaque with rapid growth and a regular or irregular shape. SK-like melanoma presents melanocytic and nonmelanocytic dermoscopic features. Irregular dark-brown dots/globules, a blue-grayish veil, streaks, irregular pigmentation or network and brown lines point to a melanoma diagnosis. Among the nonmelanocytic features, milia-like cysts and comedo-like openings have been highlighted. The association of polarized and nonpolarized dermoscopic techniques is more accurate for studying the dermoscopic features of SK-like melanoma. If the dermoscopic features are unclear, further investigations with reflectance confocal microscopy (RCM) or biopsy with histologic examination are essential. SK-like melanoma is a dermatologic challenge. Careful clinical and dermoscopic evaluation favor a correct diagnosis. In unclear cases, it is important to perform a biopsy with histologic examination to confirm the correct diagnosis.

References
More filters

Journal ArticleDOI
TL;DR: The term compound tumor is proposed to designate the finding of two distinctive neoplasms either directly contiguous with each other or immediately adjacent to each other in this association of malignant neoplasm.
Abstract: The association of malignant neoplasms arising contiguous with or adjacent to seborrheic keratoses has been previously documented. In this study a retrospective analysis was performed to further characterize these combined neoplasms. A total of 54 examples of malignant neoplasms in conjunction with seborrheic keratoses were found, of which 43 were basal cell carcinomas, six were Bowen's disease, three were keratoacanthomas, and two were malignant melanomas. The average age of the patients was over 65 years. Men were affected more frequently then women. The posterior thorax was the most common site for malignant neoplasms associated with seborrheic keratoses. The superficial type of basal cell carcinoma was the most common type of basal cell carcinoma found in this association. All subtypes of seborrheic keratosis may be found together with malignant neoplasms. We believe the appellation collision tumor is not valid because it is unknown whether the association of seborrheic keratoses with malignant neoplasms is a random event or whether there is, in fact, a pathogenic relationship in the development of two distinctive neoplasms together. Therefore, the term compound tumor is proposed to designate the finding of two distinctive neoplasms either directly contiguous with each other or immediately adjacent to each other.

115 citations


"Melanoma in-situ arising in seborrh..." refers background in this paper

  • ...Background Melanoma in-situ arising within seborrheic keratosis, while reported in the literature, is still a relatively rare entity, appearing a handful of times in the literature over the past two decades [1-4]....

    [...]


Journal ArticleDOI
TL;DR: The incidence of associated lesions, in particular malignancy arising within seborrhoeic keratoses may be higher than previously thought and should be considered for biopsy and histological examination.
Abstract: Seborrhoeic keratoses are benign epidermal neoplasms that are rarely associated with other skin lesions especially malignancies. In this study, the aim was to assess the incidence of associated lesions occurring either adjacent to or contiguous with a seborrhoeic keratosis. A retrospective case series over a 12-month period was carried out. In total, 639 consecutive histologically diagnosed seborrhoeic keratoses were identified, of which 85 (9%) were found to be associated with other lesions. Of these associated lesions, 44 (7%) were malignant, with four of these found to be arising within the seborrhoeic keratosis. These associated lesions included premalignant lesions, malignancies, melanocytic lesions and miscellaneous lesions. Men (59%) were affected more commonly than women. The average age was 74 years (range 33-98 years). Seborrhoeic keratoses associated with other lesions were found most commonly on the head and neck. The incidence of associated lesions, in particular malignancy arising within seborrhoeic keratoses may be higher than previously thought. This may be an incidental phenomenon, or seborrhoeic keratosis could represent a precursor lesion. Therefore, seborrhoeic keratoses that have undergone recent clinical change should be considered for biopsy and histological examination.

45 citations


"Melanoma in-situ arising in seborrh..." refers background in this paper

  • ...Background Melanoma in-situ arising within seborrheic keratosis, while reported in the literature, is still a relatively rare entity, appearing a handful of times in the literature over the past two decades [1-4]....

    [...]


Journal ArticleDOI
TL;DR: It is concluded that seborrheic keratoses are common and association with malignant melanoma is very rare, and because of the association of other malignancies, a biopsy of any suspect or changing sebor rheological keratosis is essential.
Abstract: We report a case of malignant melanoma associated with seborrheic keratosis. This has been reported rarely in the literature, with disagreement regarding whether it is coincidental or whether malignant transformation occurs. Because seborrheic keratoses are common and association with malignant melanoma is very rare, we conclude that the association is coincidental. However, because of the association of other malignancies, a biopsy of any suspect or changing seborrheic keratosis is essential.

40 citations


"Melanoma in-situ arising in seborrh..." refers background in this paper

  • ...Background Melanoma in-situ arising within seborrheic keratosis, while reported in the literature, is still a relatively rare entity, appearing a handful of times in the literature over the past two decades [1-4]....

    [...]


Journal ArticleDOI
TL;DR: A patient with a clinically typical-appearing SK is described, which was biopsied and histologically proven to be a malignant melanoma arising in the SK, a reminder that the reliability of clinical diagnosis of SKs needs to be questioned.
Abstract: Seborrheic keratoses (SKs) are common benign nonmelanocytic epidermal tumors with characteristic clinical features, which are thought to allow a straightforward diagnosis in most situations. As a result, it is an accepted practice to destroy them without histopathologic confirmation. However, systematic reviews of histologic specimens reveal an erroneous clinical diagnosis or associated malignant tumors in a number of cases, including malignant melanomas. We describe a patient with a clinically typical-appearing SK, which was biopsied and histologically proven to be a malignant melanoma arising in the SK. Our report is a reminder that the reliability of clinical diagnosis of SKs needs to be questioned. In addition, a biopsy of SKs is not only warranted but necessary in order to identify a malignant melanoma that would otherwise be misdiagnosed or even completely missed.

26 citations


"Melanoma in-situ arising in seborrh..." refers background in this paper

  • ...Lim [1] retrospectively reviewed 639 cases of seborrheic keratosis, of which 85 (9%) were found to be associated with other lesions....

    [...]

  • ...Background Melanoma in-situ arising within seborrheic keratosis, while reported in the literature, is still a relatively rare entity, appearing a handful of times in the literature over the past two decades [1-4]....

    [...]