Unusual features of primary dermatofibrosarcoma protuberans and its myxoid recurrence

A case of Dermatofibrosarcoma Protuberans (DFSP) with unusual clinical and histological features is presented. The lesion recurred one year after surgical removal and showed myxoid degeneration of the entire lesion. Only a few cases with myxoid degeneration of the entire lesion are described in the literature. We found CD 34 stain, in combination with a panel of antibodies including fXIIIa, S100 and actin, useful in the diagnosis of this type of tumor in order to differentiate it from other neural, fibrous or muscular neoplasms

Blue nevi and basal cell carcinoma within a speckled lentiginous nevus

We describe an unusual case of blue nevi and basal cell carcinoma arising within a speckled lentiginous nevus and discuss the relationship between epithelial tumors and nevoid growth of melanocytes

Giant basal cell carcinomas: report of four cases and considerations

Four cases of giant basal cell carcinoma (BCC) are reported and the problems of giant BCCs are briefly discussed. In particular, we consider the relationship between the size of the tumor and its clinical behaviour. The importance of the site location in tumor development the histologic subtypes involved, the associated findings, and problems of treatment are also discussed

Basal cell carcinomas of the auricular region: a study of 23 cases

Basal cell carcinomas (BCCs) of the auricular region are not frequently reported, especially in the Japanese literature. Predisposing conditions such as sun exposure or frostbite are possibly involved in their development. In this study, we report our cases of auricular BCCs, discussing the obtained results, the possible significance of predisposing conditions, and the correlation with the histologic subtypes involved. Among 1094 patients with BCCs, auricular tumors were observed in 23 patients (2.1%), 4 women and 19 men. All of them were present on the external sun-exposed auricular side. Histologic patterns were nodular and micronodular (13 cases) and infiltrative (10 cases). No differences were observed between sexes. The relative degree of elastosis was higher in men than in women. Frostbite was recorded in 4 cases. The ear is an anatomical region that is heavily exposed to sun-light and equally prone to frostbite. Our data showed that all the lesions were located on the auricular region more or less exposed to sunlight. There was a recorded previous history of predisposing factors in most cases, and the high degree of elastosis suggests the involvement of these predisposing factors. Moreover, the high prevalence of infiltrative subtypes observed in our survey suggests a possible correlation between some histologic subtypes, sun-exposure, and frostbite. The differences between the relatively high number of auricular BCCs reported in the literature in contrast with the Japanese observations suggest the involvement of social or local conditions

Pre-existing cutaneous changes in basal cell carcinomas of the lower extremities

Basal cell carcinomas (BCCs) of the lower extremities are not frequently reported. Some pre-existing or predisposing conditions are thought to be implicated in their development. In this study, we investigated the possible relationships between pre-existing cutaneous changes and the development of BCCs of the lower extremities, possible sex and age differences, and the histologic patterns involved. Among 1053 patients with BSSc, BCCs of the lower extremities were observed in 48 (4.5%): 25 men and 23 women. Lesions appeared on the thighs (16 cases), the lower legs (27 cases), or the feet (5 cases). Histologic patterns were nodular and micronodular (18 cases), superficial (27 cases), or infiltrative (3 cases). No differences were observed between sexes. The relative degree of elastosis was higher in the lower limbs of women than of men (2.25 vs 1.53). Pre-existing cutaneous changes were observed in 7 cases. The frequency of these BCCs of the lower limbs and the higher degree of elastosis observed in the women seem to be related to sun exposure. The histologic pattern seems not to be affected by environmental factors but rather characteristic of body site. Pre-existent cutaneous changes are not thought to be possible etiologic factors

Molluscum contagiosum in a soft fibroma: a particular combined lesion

A case of a single molluscum contagiosum occurring on the surface of a preexisting soft fibroma in an adult patient is reported. The most common clinical form of this viral lesion is multiple grouping papules with a central umbilication and its histologic feature is characteristic. Previous cases of mollusca combining with other lesions have been rarely described. Our lesion was probably due to its localization on the soft fibroma, whose exophytic growing represented a favoring factor for trauma and the consequent occurrence of the viral disease

Bilateral spectacle frame acanthoma

We report the case of a young white male with bilateral retroauricular spectacle frame acanthoma which developed within a few weeks of wearing ill-fitting sunglasses. Bilateral cases have only rarely been reported. This lesion must be differentiated from malignant proliferative conditions

Small congenital nevi associated with melanoma: case reports and considerations

Melanocytic nevi, both congenital and acquired, are considered to be precursors of melanomas. Data about the malignant potential of these nevi are conflicting, particularly with reference to the nevus of the smallest size. Patients with preexisting melanocytic nevi (both congenital and acquired) have risks of developing melanoma that differ from those of subjects without them. The purpose of this study was to verify the presence of melanoma in preexisting nevi both congenital (congenital nevus associated melanoma) (CNAM) and acquired (ANAM). In particular, we investigated melanomas associated with small congenital nevi (SCN). A cohort of 190 patients with primary melanomas was studied. Congenital nevi were called "small" (SCN) when their diameters were less than 1.5 cm. Epiluminescence microscopy (ELM) was performed to further improve the clinical diagnosis and to observe the more subtle changes in the preexisting nevi. Forty of the 190 cases of melanoma were associated with preexisting nevi; of these, 15 had congenital features with a CNAM largest diameter of 1.5 cm. These 15 cases were melanomas of the superficial type with a mean tumor thickness lower than that of ANAM (0.33 vs 1.50). There were no differences between the locations of CNAM and other melanomas. Male patients were significantly more affected. ELM microscopy permitted us to detect the early malignant changes in nevi and thus to improve our diagnosis. A high percentage of small congenital nevi were found to be associated with melanomas. They may be considered as melanomas precursors. Because of their large number and frequency, prophylactic removal of all SCN is not feasible. However, they should be removed as soon as possible when clinical or ELM changes are observed