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Goto K, Ogawa K, Hishima T, Oishi N, Tomita O, Tsuyuki T, Oda T, Iwahashi Y, Inaba Y, Honma K. Seborrheic Keratosis With Malignant Transformation (Invasive or Noninvasive Squamous Cell Carcinoma Arising in Seborrheic Keratosis): A Clinicopathologic and Immunohistochemical Study of 11 Cases. Am J Dermatopathol 2022; 44:891-899. [PMID: 36395445 DOI: 10.1097/dad.0000000000002245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Seborrheic keratosis is a common benign neoplasm composed of basaloid keratinocytes. However, little is known about the malignant transformation of the tumor. Eleven cases of seborrheic keratosis with malignant transformation were analyzed. The 11 patients included 5 male patients and 6 female patients with a median age of 75 years at diagnosis (68-90 years). The tumors arose at various sites from the scalp (n = 3) to the lower leg (n = 2). The median tumor size was 12 (10-32) and 40 (20-75) mm in 7 noninvasive and 4 invasive cases, respectively. One patient exhibited in-transit skin metastasis. Histopathology of the malignant components resembled porocarcinoma or inverted follicular keratosis. Bowenoid and pagetoid spreading was frequently observed. The malignant components expressed cytokeratin 5/6 (100%) and GATA3 (73%), but not cytokeratin 7 (0%), cytokeratin 19 (9%), BerEP4 (0%), c-kit (0%), and NUT (0%). No significant immunoreactivity of YAP1 was observed in any of the cases. Mutant-type immunostaining of p53 and PTEN was observed in 91% and 82% of the cases, respectively. An increase in p16 expression was seen in 6 (86%) of the 7 cases with noninvasive carcinoma, although a loss of p16 immunoexpression was seen in the invasive carcinoma component in 3 (75%) of the 4 cases. This study demonstrated that seborrheic keratosis can undergo malignant transformation, particularly in large-sized lesions in elderly patients. Malignant components mimic porocarcinoma or inverted follicular keratosis. Malignant transformation induced by TP53 and PTEN mutations and tumor invasion by CDKN2A inactivating mutations are suggested in this study.
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Affiliation(s)
- Keisuke Goto
- Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka, Japan
- Department of Pathology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
- Department of Pathology, Itabashi Central Clinical Laboratory, Tokyo, Japan
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
- Department of Diagnostic Pathology, Shizuoka Cancer Center Hospital, Sunto, Japan
- Department of Clinical Laboratory and Diagnostic Pathology, Osaka National Hospital, Osaka, Japan
- Department of Dermatology, Hyogo Cancer Center, Akashi, Japan
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Kohei Ogawa
- Department of Dermatology, Nara Medical University School of Medicine, Kashihara, Japan
| | - Tsunekazu Hishima
- Department of Pathology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
| | | | - Ozumi Tomita
- Dermatology, Faculty of Medicine, University of Yamanashi, Chuo, Japan
| | | | - Takao Oda
- Dermatology, Kainan Hospital, Yatomi, Japan ; and
| | | | - Yutaka Inaba
- Dermatology, Wakayama Medical University, Wakayama, Japan
| | - Keiichiro Honma
- Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka, Japan
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Goldsmith JF, Montaser Kouhsari L, Tahan SR. Clonal-pattern Seborrheic Keratosis: Risk of Recurrence and Progression to Carcinoma. Am J Surg Pathol 2022; 46:1642-1649. [PMID: 36221316 DOI: 10.1097/pas.0000000000001973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Seborrheic keratosis is a benign epidermal tumor. Seborrheic keratosis with clonal pattern (CPSK) displays histologic features distinct from other subtypes of SK (non-CPSK). We sought to quantitatively assess the risk of recurrence and progression to squamous cell carcinoma (SCC), either in situ or invasive, of incompletely excised CPSKs. We studied all 244 cases from 238 patients of "seborrheic keratosis, clonal pattern" diagnosed in our institution over a 10-year period (2008-2018). Demographic, clinical, pathologic, and follow-up data were gleaned from electronic health records. Following glass slide review, CPSK lesions were divided into 2 groups: CPSK with cytologic atypia and CPSK without cytologic atypia. For comparison, 107 non-CPSKs were studied as controls. The minimum follow-up period was 2 years (median=4 y). All lesions were incompletely excised. Eighteen of 244 CPSKs (7.4%) recurred at or adjacent to the site of initial partial removal compared with 1.9% of non-CPSKs. Five of the 18 (28%) recurrent CPSKs recurred as CPSK, 11 (61%) as SCC in situ, and 3 (17%) as invasive SCC. The mean time to recurrence was 3.1 years. Two non-CPSKs recurred as non-CPSKs. Overall CPSKs were more likely to recur than non-CPSKs ( P =0.04). CPSKs with atypia were more likely to recur than CPSKs without atypia ( P =0.03). The upgrade rate to SCC at least in situ of all recurrent CPSK lesions with atypia was 78%. Our results suggest that pathologists should report the presence of clonal pattern when observed in seborrheic keratoses, indicate the presence of atypia, and provide lesional margin assessment.
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Affiliation(s)
- Joshua F Goldsmith
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
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[Occult basal cell carcinoma intermingling with seborrheic keratosis of the eyelid : A clinicopathological case report]. DIE OPHTHALMOLOGIE 2022; 119:636-638. [PMID: 34043084 DOI: 10.1007/s00347-021-01407-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 04/21/2021] [Accepted: 04/25/2021] [Indexed: 01/26/2023]
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Ye Q, Chen KJ, Jia M, Fang S. Clinical and Histopathological Characteristics of Tumors Arising in Seborrheic Keratosis: A Study of 1365 Cases. Ther Clin Risk Manag 2021; 17:1135-1143. [PMID: 34737570 PMCID: PMC8558104 DOI: 10.2147/tcrm.s316988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 10/12/2021] [Indexed: 12/03/2022] Open
Abstract
Objective The aim of this study was to describe the clinical and histopathological characteristics of seborrheic keratosis (SK) with secondary tumor and identify associated factors. Methods This study was a monocentric retrospective case-control study describing the factors associated with the development of tumors in SK. A total of 1365 patients with SK were admitted to our department between 2018 and 2021. All of the histopathological specimens and medical records of these patients were reviewed. We compared the data of 36 patients with tumors arising in SK with those of the remaining 1329 patients with only SK, which were designated the control group. Results The incidence of tumors arising in SK that were biopsied was 2.6%. The tumor types included squamous cell carcinoma (SCC), basal cell carcinoma (BCC) and keratoacanthoma (KA). Compared with other patients with SK, elderly patients with immunosuppression, patients presenting surrounding erythema or ulceration, and those with SK in exposed areas had an increased possibility of developing a secondary tumor. Tumors arising within SK have the histopathological features of ulceration, cytologic atypia, mitosis, “malignant horn”, trabecular cell cords, solar elastosis and severe inflammatory infiltration in the dermis. Conclusion SK can show malignant progression in a small fraction of SK cases that are biopsied. This study is the first report on the clinical and histopathological characteristics of tumors arising in SK and identifies relevant factors in an Asian population.
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Affiliation(s)
- Qian Ye
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Ke-Jun Chen
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Meng Jia
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Sheng Fang
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
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Fang S, Zhou Z, Wu Y, Zheng Z, Zhao Y, Sun X, Wang X, Zhang G. Photodynamic therapy combined with carbon dioxide laser for successful treatment of cutaneous squamous cell carcinoma within a long-standing and huge seborrheic keratosis. Photodiagnosis Photodyn Ther 2021; 36:102536. [PMID: 34536605 DOI: 10.1016/j.pdpdt.2021.102536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 09/12/2021] [Accepted: 09/13/2021] [Indexed: 10/20/2022]
Abstract
Seborrheic keratosis (SK) is a common benign lesion in which malignancies like cutaneous squamous cell carcinoma (cSCC) can arise rarely. We report a case of an 81-year-old man who presented a well-demarcated reddish-brown plaque with central raised coarse nodules on the top of his head. Dermoscopy and reflectance confocal microscopy (RCM) showed the possibility of malignant transformation. cSCC was confirmed by histopathology and immunohistochemistry. Considering the fact of local low-risk cSCC within a large SK lesion, carbon dioxide (CO2) laser was used to treat the SK lesion, and reduce the thickness of local cSCC simultaneously. Three sessions of 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) were performed after CO2 laser. Finally, no atypical cells were found by multi-point biopsy after treatment, and follow-up was continued for one year. Therefore, malignant changes of SK are relatively uncommon, but should be suspected when abnormal appearance or symptoms occurred. ALA-PDT combined with CO2 is a safe, effective, and minimally invasive treatment for cSCC arising from a huge SK.
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Affiliation(s)
- Shan Fang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai 200092, China
| | - Zhongxia Zhou
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai 200092, China
| | - Yuhao Wu
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai 200092, China
| | - Zhe Zheng
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai 200092, China
| | - Yan Zhao
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai 200092, China
| | - Xiaofei Sun
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai 200092, China
| | - Xiuli Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai 200092, China.
| | - Guolong Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai 200092, China.
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Cohen PR, Calame A. Multiple Skin Neoplasms at One Site (MUSK IN A NEST): A Comprehensive Review of Basal Cell Carcinoma and Benign or Malignant "Collision" Tumors at the Same Cutaneous Location. Clin Cosmet Investig Dermatol 2020; 13:731-741. [PMID: 33061513 PMCID: PMC7532883 DOI: 10.2147/ccid.s259324] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 09/04/2020] [Indexed: 11/23/2022]
Abstract
Multiple skin neoplasms at one site (MUSK IN A NEST), initially referred to as a collision tumor, describes the occurrence of two or more benign or malignant neoplasms that are adjacent or intermingled at the same cutaneous site. A mononeoplastic cutaneous tumor refers to a single tumor at any cutaneous site. Two, three, four, five, and six tumors at the same site are described as dineoplastic, trineoplastic, tetraneoplastic, pentaneoplastic, and hexaneoplastic cutaneous tumors, respectively; the prefixes are based on the numerical multiplier used by the International Union of Pure and Applied Chemistry (IUPAC). MUSK IN A NEST can be classified based upon their mechanism of pathogenesis-either being composed of mixed clones of cells (clonalium, which has three subtypes: collision, colonization, and combination) or the same clone of cells that has undergone clonal evolution (clonalidem, which has one subtype: biphenotypic). Basal cell carcinoma (BCC)-associated MUSK IN A NEST can be observed with either benign tumors, malignant tumors, or both. Nevi and seborrheic keratoses are the most common benign tumors associated with BCC; melanoma in situ and invasive melanoma are the most commonly reported malignant tumors associated with BCC. The definitive etiology of BCC-associated MUSK IN A NEST remains to be established-whether the development of the BCC at that site occurs as a direct or indirect consequence of the coexisting neoplasm or whether the occurrence of the BCC and the other neoplasm is merely the result of a coincidental juxtaposition of the tumors.
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Flordelis JO, Shen YC, Wu YH. Basaloid tumors arising from seborrheic keratosis: Malignant basal cell carcinoma or benign basaloid follicular hamartomatous proliferation? J Cutan Pathol 2019; 47:207-218. [PMID: 31682281 DOI: 10.1111/cup.13607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 10/22/2019] [Accepted: 10/28/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Basaloid tumors arising from seborrheic keratosis (SK) that resembled basal cell carcinoma (BCC) were infrequently observed in our patients. They also exhibited morphologic features similar to those of trichoblastoma or basaloid follicular hamartoma. METHODS We retrospectively collected cases of SK with basaloid tumors from 2001 to 2017. Ten cases of BCC, five of nevus sebaceus with trichoblastoma, five of trichoblastoma, and five of trichoepithelioma were included as controls. Tumor-associated antigens Bcl-2, CD10, PHLDA1, and CK20 were tested. Antigenic markers CD34 and CD10 were used to analyze peritumoral stroma features and Ki-67 and pHH3 to measure the mitotic activity. RESULTS Ten cases of SK with basaloid tumors were found and all located in non-sun-exposed areas, including five men and five women, with a mean age of 61 years. A distinct PHLDA1 staining was not observed. The staining patterns of basaloid tumor lobules associated with SK were similar to the benign control group. Bcl-2 staining in the tumor lobules was mostly negative. Peritumoral CD10 stain and CK20-positive Merkel cells in the lobules were observed and the mitotic counts were low. CONCLUSION Basaloid tumors arising from SK are not always BCC. They were all benign follicular hamartomatous proliferation in this case series.
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Affiliation(s)
- Johanna O Flordelis
- Department of Dermatology, Research Institute for Tropical Medicine, Metro Manila, Philippines
| | - Ying-Chi Shen
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
| | - Yu-Hung Wu
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.,Department of Dermatology, Mackay Memorial Hospital, Taipei, Taiwan
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Cimpean I, Theate I, Vanhooteghem O. Seborrheic keratosis evolution into squamous cell carcinoma: A truly modified sun-related tumor? A case report and review of the literature. Dermatol Reports 2019; 11:7999. [PMID: 31044056 PMCID: PMC6477930 DOI: 10.4081/dr.2019.7999] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 03/14/2019] [Indexed: 11/23/2022] Open
Abstract
The incidence of seborrheic keratosis (SK) generally increases with age and are mostly localized on the trunk, face and neck, especially on sun-exposed areas. The association between SK and skin malignancies appears to be accidental, but in situ transformation occurs more frequently in sun-exposed areas. Histopathological examination of all SK cases should be considered, especially when SK lesions exhibit atypical clinical manifestations, such as ulceration and cresting, as they may herald malignant transformation. In addition, other features associated with malignant transformation include excoriations or hemorrhages identified on the lesion, modification and evolution of the macroscopic characteristics, and the presence of local erythema or pruritus. Immunocompromised patients exhibit an increased risk of malignant transformation, even when radiation is involved.
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Affiliation(s)
- Ioana Cimpean
- Department of Dermatology, Saint Elisabeth Hospital, CHU UCL Namur
| | - Ivan Theate
- Department of Pathology, IPG Gosselies, Belgium
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Hillen LM, Rennspiess D, Speel EJ, Haugg AM, Winnepenninckx V, Zur Hausen A. Detection of Merkel Cell Polyomavirus in Seborrheic Keratosis. Front Microbiol 2018; 8:2648. [PMID: 29375515 PMCID: PMC5767171 DOI: 10.3389/fmicb.2017.02648] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 12/19/2017] [Indexed: 11/20/2022] Open
Abstract
Seborrheic keratosis (SK) is the most common benign cutaneous neoplasm. A subset shows increased p16 expression. Since SK shares several features with verruca vulgaris, e.g., increased p16 expression, human papillomaviruses (HPV) have been suggested as possible causal agents. However, a relevant association could not be established between HPV and SK. In the present study we aimed to investigate the presence of Merkel cell polyomavirus (MCPyV) in relation to p16 expression in SK. P16 expression was investigated using immunohistochemistry (IHC). Presence of MCPyV was assessed in 23 formalin-fixed paraffin-embedded tissue samples of SK by molecular techniques (i.e., PCR and FISH) and IHC. 16/23 SK showed strong to moderate p16 expression. 6/23 of SK were MCPyV positive by PCR which was confirmed by FISH. Of interest, two samples with strong FISH signals also showed MCPyV expression as tested by IHC. Samples with weaker signal intensity were negative in IHC. P16 expression was not associated with the presence of MCPyV. Concluding, the detection of MCPyV DNA by PCR and FISH in SK reflects the widespread prevalence of MCPyV in the skin. However, low detection rates exclude MCPyV as a major pathogenic factor in SK, most likely representing a coincidental infection. P16 IHC does not appear as useful adjunctive surrogate marker for the presence of MCPyV in SK.
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Affiliation(s)
- Lisa M Hillen
- Department of Pathology and GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, Netherlands
| | - Dorit Rennspiess
- Department of Pathology and GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, Netherlands
| | - Ernst-Jan Speel
- Department of Pathology and GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, Netherlands
| | - Anke M Haugg
- Department of Gynaecology, University Hospital RWTH Aachen, Aachen, Germany
| | - Véronique Winnepenninckx
- Department of Pathology and GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, Netherlands
| | - Axel Zur Hausen
- Department of Pathology and GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, Netherlands
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Kogame T, Tanimura H, Nakamaru S, Makimura K, Okamoto H, Kiyohara T. Spindle cell squamous cell carcinoma arising in Bowen's disease: Case report and review of the published work. J Dermatol 2017; 44:1055-1058. [PMID: 28370387 DOI: 10.1111/1346-8138.13845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 02/16/2017] [Indexed: 11/29/2022]
Abstract
A 79-year-old Japanese woman presented with an ulcerated, brown-red nodule in the center of a sharply demarcated, tan-brown plaque situated on the left side of her right breast. Histologically, the plaque demonstrated an acanthosis with an intraepidermal epithelioma of Borst-Jadassohn. Small oval nests of bland-appearing basophilic cells in the periphery gradually enlarged into nests of various sizes and irregular shapes, composed of densely cohesive, atypical basophilic cells above the central nodule. The atypical keratinocytes shifted to atypical spindle cells beneath the acanthotic epidermis, penetrating deep into the subcutaneous tissue. In addition to vimentin and p63, the spindle cells were positive for several cytokeratin (CK) markers, including AE1/AE3, 34βE12 and CK5/6, which showed more intense signals closer to the epidermis. Basophilic cells in the clonal nests were positive for p63, AE1/AE3, 34βE12 and CK5/6. The MIB-1 index was estimated at approximately 40-50% in both the bland-appearing and the atypical basophilic cells. We describe the first case of spindle cell squamous cell carcinoma arising in an intraepidermal epithelioma expressed by clonal Bowen's disease, which was difficult to differentiate from clonal seborrheic keratosis.
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Affiliation(s)
- Toshiaki Kogame
- Department of Dermatology, Kansai Medical University Hospital, Osaka, Japan
| | - Hirotsugu Tanimura
- Department of Dermatology, Kansai Medical University Medical Center, Osaka, Japan
| | - Sei Nakamaru
- Department of Dermatology, Kansai Medical University Medical Center, Osaka, Japan
| | - Kaoru Makimura
- Department of Dermatology, Kansai Medical University Medical Center, Osaka, Japan
| | - Hiroyuki Okamoto
- Department of Dermatology, Kansai Medical University Hospital, Osaka, Japan
| | - Takahiro Kiyohara
- Department of Dermatology, Kansai Medical University Medical Center, Osaka, Japan
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Conic RZ, Napekoski K, Schuetz H, Piliang M, Bergfeld W, Atanaskova Mesinkovska N. The role of immunosuppression in squamous cell carcinomas arising in seborrheic keratosis. J Am Acad Dermatol 2017; 76:1146-1150. [PMID: 28162852 DOI: 10.1016/j.jaad.2016.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 11/30/2016] [Accepted: 12/01/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Seborrheic keratoses (SK) are common skin neoplasms considered to be benign. Reports of associated squamous cell carcinoma arising within seborrheic keratosis (SCC-SK) have been described. OBJECTIVE To describe the histopathologic characteristics of SCC-SK and identify predisposing factors in formation of these rare lesions. METHODS There were 162 cases of SCC-SK in a span of a decade (2003-2014). All of the histopathologic specimens and medical records were reviewed. Data from these patients were compared to a control group with seborrheic keratosis who were matched by age, sex, and location of lesion from the same time period (n = 162). RESULTS SCC-SK has the classic histopathologic features of SK, such as hyperkeratosis, parakeratosis, papillomatosis, and pseudohorn cysts. The areas of squamous cell carcinoma were characterized by areas of squamous dysplasia (100%), hypogranulosis (79.6%), squamous eddies (79.6%), solar elastosis (80.9%), and brown pigmentation (59.9%). Patients with a history of immunosuppression had an increased risk for developing SCC-SK (19% vs 3%; P < .01), particularly when inhibition was transplant-associated (10% vs 0%; P < .01). LIMITATIONS This was a single center, retrospective study. CONCLUSION SCC-SK occurs more often in elderly men with a history of immunosuppression associated with organ transplants.
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Affiliation(s)
- Ruzica Z Conic
- Department of Dermatology and Dermatopathology, Cleveland Clinic, Cleveland, Ohio; Department of Dermatology, Case Western Reserve University, Cleveland, Ohio.
| | - Karl Napekoski
- Department of Pathology, Edward Hospital, Naperville, Illinois
| | - Heidi Schuetz
- Department of Dermatology and Dermatopathology, Cleveland Clinic, Cleveland, Ohio
| | - Melissa Piliang
- Department of Dermatology and Dermatopathology, Cleveland Clinic, Cleveland, Ohio
| | - Wilma Bergfeld
- Department of Dermatology and Dermatopathology, Cleveland Clinic, Cleveland, Ohio
| | - Natasha Atanaskova Mesinkovska
- Department of Dermatology and Dermatopathology, Cleveland Clinic, Cleveland, Ohio; Department of Dermatology and Dermatopathology, University of California Irvine, Irvine, California
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Gupta D, Singh N, Goyal A, Toi PC, Thappa DM. Squamous Cell Carcinoma in-situ and Basal Cell Carcinoma Arising From Seborrheic Keratosis in the Same Patient. Indian J Dermatol 2016; 61:126. [PMID: 26955160 PMCID: PMC4763677 DOI: 10.4103/0019-5154.174178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Divya Gupta
- Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Nidhi Singh
- Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Ajay Goyal
- Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Pampa Ch Toi
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India. E-mail:
| | - Devinder Mohan Thappa
- Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Fusco N, Lopez G, Gianelli U. Basal Cell Carcinoma and Seborrheic Keratosis: When Opposites Attract. Int J Surg Pathol 2015; 23:464. [PMID: 26135529 DOI: 10.1177/1066896915593802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Nicola Fusco
- Fondazione IRCSS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Umberto Gianelli
- Fondazione IRCSS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy University of Milan, Milan, Italy
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Aleksandrova AK, Smolyannikova VA. Seborrheic keratosis: current concepts of pathogenesis. VESTNIK DERMATOLOGII I VENEROLOGII 2014. [DOI: 10.25208/0042-4609-2014-90-4-28-34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The article covers problems of seborrheic keratosis. The authors discuss current concepts of the etiology and pathogenesis of the disease paying special attention to the histology and immunohistochemistry of different forms and diverse clinical presentations. They describe Leser - Trelat syndrome as well as potential neoplastic transformation of seborrheic keratomas and their association with malignant skin neoplasms.
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Boyd AS, Su PF, Shyr Y, Tang YW. Squamous cell carcinomasin situarising in seborrheic keratoses: an association with concomitant immunosuppression? Int J Dermatol 2014; 53:1346-50. [DOI: 10.1111/ijd.12086] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Alan S. Boyd
- Department of Medicine (Dermatology); Vanderbilt University; Nashville TN USA
- Department of Pathology; Vanderbilt University; Nashville TN USA
| | - Pei F. Su
- Department of Biostatistics; Vanderbilt University; Nashville TN USA
| | - Yu Shyr
- Department of Biostatistics; Vanderbilt University; Nashville TN USA
| | - Yi W. Tang
- Department of Clinical Microbiology Service; Memorial Sloan-Kettering Cancer Center; New York NY USA
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Botelho LFF, Michalany NS, Enokihara MMSES, Hirata SH. Dysplastic nevus associated with seborrheic keratosis. An Bras Dermatol 2014; 89:160-2. [PMID: 24626665 PMCID: PMC3938371 DOI: 10.1590/abd1806-4841.20142222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Accepted: 12/28/2012] [Indexed: 11/22/2022] Open
Abstract
Seborrheic keratosis is a common skin lesion which may coincidentally be associated melanocytic nevi. The authors describe a case of dysplastic nevus associated with seborrheic keratosis and discuss the clinical, dermoscopic, and histological findings of this association. They also discuss the association between seborrheic keratosis and other benign and malignant tumours.
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Affiliation(s)
- Luciane Francisca Fernandes Botelho
- Federal University of Sao Paulo, Department of Dermatology, Sao PauloSP, Brazil, Masters student, Department of Dermatology, Federal University of Sao Paulo (UNIFESP) - Sao Paulo (SP), Brazil
| | - Nilceo Schwery Michalany
- Federal University of Sao Paulo, Department of Pathology, Sao PauloSP, Brazil, Masters in General Anatomical Pathology - Associate Professor, Department of Pathology, Federal University of Sao Paulo (UNIFESP) - Sao Paulo (SP), Brazil
| | - Milvia Maria Simões e Silva Enokihara
- Federal University of Sao Paulo, Departments of Dermatology and Pathology, Sao PauloSP, Brazil, PhD in Pathology from Federal University of Sao Paulo (UNIFESP) - Dermatopathologist from Departments of Dermatology and Pathology, Federal University of Sao Paulo (UNIFESP) - Sao Paulo (SP), Brazil
| | - Sergio Henrique Hirata
- Federal University of Sao Paulo, Departments of Dermatology, Sao PauloSP, Brazil, PhD in Dermatology from Federal University of Sao Paulo (UNIFESP) - Adjunct Professor, Department of Dermatology, Federal University of Sao Paulo (UNIFESP) - Sao Paulo (SP), Brazil
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Gaffney DC, Muir JB, De'Ambrosis B. Malignant change in seborrhoeic keratoses in a region with high solar ultraviolet levels. Australas J Dermatol 2013; 55:142-4. [PMID: 23573958 DOI: 10.1111/ajd.12035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 12/30/2012] [Indexed: 11/28/2022]
Abstract
Regions with high solar UV levels and high skin cancer rates may experience a greater incidence of malignancy in association with seborrhoeic keratoses (SebK) than in low UV regions. Previous reports have indicated that basal cell carcinoma is the most common neoplasm with reported rates of up to 4 per cent of excised SebK. The rates of such compound lesions occurring in our practice were reviewed, indicating that Bowen's disease was the most frequently observed neoplasm with a rate of 7 per cent. In total, 10 per cent of all excised specimens showed either frank malignancy or some degree of atypia.
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Affiliation(s)
- Daniel C Gaffney
- Department of Dermatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
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Zaballos P, Bañuls J, Cabo H, Llambrich A, Salsench E, Puig S, Pizarro A, Malvehy J. The usefulness of dermoscopy for the recognition of basal cell carcinoma--seborrhoeic keratosis compound tumours. Australas J Dermatol 2012; 54:208-12. [PMID: 23043582 DOI: 10.1111/j.1440-0960.2012.00953.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Accepted: 08/03/2012] [Indexed: 11/26/2022]
Affiliation(s)
- Pedro Zaballos
- Dermatology Department, Hospital Sant Pau i Santa Tecla, Rambla Vella 14, Tarragona, Spain.
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20
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Terada T. Pigmented Bowen disease arising in pigmented reticulated seborrheic keratosis. Int J Clin Oncol 2010; 15:608-10. [PMID: 20425131 DOI: 10.1007/s10147-010-0086-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2010] [Accepted: 04/08/2010] [Indexed: 11/30/2022]
Abstract
A 76-year-old man consulted to our hospital complaining of a black tumor of the temporal head. The tumor was nodular mass measuring 1 × 1 × 0.6 cm and black. A clinical diagnosis of basal cell carcinoma was made, and an excision with wide margins was performed. Histologically, the tumor was symmetrical, with horny keratinization in the center. An aggregate of atypical cells regarded as malignant cells was present in the center. No invasion was recognized. The cells were heavily pigmented. Mitotic figures, individual keratinization, and clumping cells were also recognized. Numerous dendritic melanocytes were recognized in the malignant lesion. Immunohistochemically, strong p53 expression was present in all malignant cells, and the malignant cells showed a high Ki-67 labeling of 60%. They were negative for melanosome and S100 protein and positive for cytokeratins. The periphery of the tumor showed typical features of pigmented reticulated seborrheic keratosis. There were gradual merges between the two lesions. This case suggests that pigmented Bowen disease can arise in pigmented reticulated seborrheic keratosis.
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Affiliation(s)
- Tadashi Terada
- Department of Pathology, Shizuoka City Shimizu Hospital, Miyakami 1231, Shimizu-Ku, Shizuoka 424-8636, Japan.
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21
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Carnero L, Soloeta R, Arbide N, González-Pérez R. Carcinoma epidermoide sobre queratosis seborreica. ACTAS DERMO-SIFILIOGRAFICAS 2009. [DOI: 10.1016/s0001-7310(09)71915-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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22
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Oyama N, Kaneko F. Trichilemmal carcinoma arising in seborrheic keratosis: a case report and published work review. J Dermatol 2009; 35:782-5. [PMID: 19239559 DOI: 10.1111/j.1346-8138.2008.00569.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The secondary skin malignancies arising in seborrheic keratosis (SK) are uncommon, and the causal association between the pre-existing lesion and subsequent malignant transformation remains uncertain. Among these enigmatic conditions, trichilemmal differentiation and/or neoplasms in SK have rarely been reported thus far. Herein, we describe a case of invasive trichilemmal carcinoma arising in a long-standing SK of the abdominal skin, and clinicopathologically review this rare complication with a computerized medical published work search (PubMed) and citations from earlier reports. To our knowledge, only four cases of trichilemmal tumors arising in SK have been observed, and, interestingly, all cases, including ours, were Japanese. Four of five cases (80%) developed the tumors in non-sun-exposed SK, and indeed had no apparent actinic damage in the histology. The pre-existing SK itself is more likely to act as the primary pathogenic event for developing the secondary trichilemmal tumors than a coincidental phenomenon and a consequence of skin damage by cumulative sun exposure.
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Affiliation(s)
- Noritaka Oyama
- Dermatology and Dermato-Allergology Clinic, Research Institute for Neuroscience, Southern Tohoku General Hospital, Fukushima, Japan.
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Squamous Cell Carcinoma on Seborrheic Keratosis. ACTAS DERMO-SIFILIOGRAFICAS 2009. [DOI: 10.1016/s1578-2190(09)70135-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Hafner C, Hartmann A, van Oers JMM, Stoehr R, Zwarthoff EC, Hofstaedter F, Landthaler M, Vogt T. FGFR3 mutations in seborrheic keratoses are already present in flat lesions and associated with age and localization. Mod Pathol 2007; 20:895-903. [PMID: 17585316 DOI: 10.1038/modpathol.3800837] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Somatic activating fibroblast growth factor 3 (FGFR3) mutations in human skin can cause seborrheic keratoses, one of the most frequent skin tumors in man. However, details of the involved mechanisms remain elusive. We analyzed 65 acanthotic seborrheic keratoses with varying vertical diameters for FGFR3 mutations using a SNaPshot multiplex assay. Immunohistochemistry was performed for Ki-67, bcl-2 and FGFR3 protein in all seborrheic keratoses and 19 normal skin samples. FGFR3 mutations were detected in 37 of 65 seborrheic keratoses (57%). These mutations were found both in flat (initial) and thick seborrheic keratoses. FGFR3 mutations were significantly associated with increased age and localization on the head and neck (P<0.01). Ki-67 expression was significantly higher in seborrheic keratoses than in normal epidermis independent of the FGFR3 status (P<0.001). Furthermore, FGFR3 mutations were associated with an increased expression of bcl-2 and FGFR3 protein (P<0.05). Our results indicate that FGFR3 mutations can occur early in the pathogenesis of at least a subset of seborrheic keratoses. Increased age appears to be a risk factor for these mutations. The preferential occurrence of FGFR3 mutations in seborrheic keratoses of the head and neck suggests a causative role for cumulative lifetime ultraviolet light exposure.
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Affiliation(s)
- Christian Hafner
- Department of Dermatology, University of Regensburg, Regensburg, Germany.
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Abstract
A 52-year-old woman presented with a 2-year history of a reddish nodule on the right nasolabial sulcus. Histopathological examination revealed that the nodule was composed of trichofolliculoma and basal cell carcinoma. There was no transitional zone between the two neoplasms. The diagnosis was made as a collision tumour of trichofolliculoma and basal cell carcinoma.
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Affiliation(s)
- Cetin Boran
- Department of Pathology, Izzet Baysal Medical Faculty, Abant Izzet Baysal University, Bolu, Turkey.
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