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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.
Abstract: Background 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.

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Citations
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Journal ArticleDOI
TL;DR: A singular case of pigmented pagetoid Bowen's disease showing transitional features between extramammary Paget’s disease and in situ squamous cell carcinoma is reported.
Abstract: Differentiation of pagetoid cutaneous neoplasms can be very challenging on hematoxylin and eosin-stained sections. We report a singular case of pigmented pagetoid Bowen’s disease showing transitional features between extramammary Paget’s disease and in situ squamous cell carcinoma.
Journal ArticleDOI
TL;DR: An 87-year-old woman with a history of multiple basal cell carcinomas presented to a follow-up visit referring a pigmented, slowly growing lesion on her right scapula that had been present for one year.
Abstract: An 87-year-old woman with a history of multiple basal cell carcinomas presented to a follow-up visit referring a pigmented, slowly growing lesion on her right scapula that had been present for one year. Physical examination revealed an irregular 12 x 5 mm well circumscribed pigmented lesion with an elevated keratotic surface (Figure 1). The dermoscopic evaluation revealed a multicomponent pattern: many colors, superior irregular pigmented network with blue-white veil and inferior cerebriform pattern surrounded by atypical pigmented network with sharp demarcation (Figure 2). The patient underwent complete exeresis of the lesion and the specimen was stained with hematoxylin-eosin. Histopathological examination showed a papillomatous epidermal hyperplasia with hyperkeratosis and cell nests in the dermoepidermal junction (Figure 3) and proliferation of atypical intraepidermal melanocytes with a pagetoid spread (Figure 4). What is your diagnosis? An irregular pigmented lesion on the back
Journal ArticleDOI
TL;DR: In this article , the authors compared two modalities of treatment for seborrheic keratosis, namely, cryotherapy and hydrogen peroxide (30%), in two groups, each with 15 patients.
Abstract: Seborrheic keratosis has a varying degree of pigmentation. In pigmented seborrheic keratosis, the proliferating keratinocytes trigger the activation of neighboring melanocytes by secreting melanocyte-stimulating cytokines. The etiology of seborrheic keratosis is not known. Epidermal growth factors or their receptors have been implicated in the development of seborrheic keratosis. Seborrheic keratoses can safely be left alone, but ugly or easily traumatized ones can be removed with cryotherapy, electrodesiccation, curettage, or shave excision. The present work aims to compare two modalities of treatment for seborrheic keratosis, namely cryotherapy and hydrogen peroxide (30%). Methods: 30 patients with seborrheic keratosis were included in this study. They were divided into two groups, each with 15 patients. The treatment modalities that have been used include cryotherapy and hydrogen peroxide in three different concentrations (30%, 35%, and 40%). Result: The cryotherapy group consisted of 15 patients, 7 males and 8 females. Their ages ranged from 38 to 80 years, with a mean of 56.1 ± 11.4. Clinical and photographic assessments showed complete removal in all 15 patients in this group (100%). As regards the hydrogen peroxide group, this group included 15 patients, distributed among 7 males and 8 females. Their ages ranged from 39 to 90 years, with a mean of 53.9 ± 14.4. Clinical and photographic assessments showed response in only one small superficial lesion in one patient (6.7%) and no response in 14 patients (93.3%). Conclusion: Cryotherapy is an effective, easy, and relatively cheap method for treating seborrheic keratosis.
References
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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.

123 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.

51 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.

41 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.

27 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]....

    [...]