Poster
# 13
Poster |
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6th Internet World Congress for Biomedical Sciences |
leonardo bugatti(1), giorgio filosa(2), massimiliano nicolini(3), roberto verdolini(4)
(1)(2)dept of dermatology. "A. Murri" Hospital Jesi - Jesi. Italy
(3)(4)Dept of Dermatology. "A. Murri" Hospital Jesi - jesi . Italy
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[Dermatology] |
[Pathology] |
We describe the case of a 63 year-old man affected by chronic skin ulcers of the left leg developed on the site of a paraffinoma. Paraffinoma was the product of an oily injection at the age of 19 in order to produce an artefacatual arthritis and avoid the military service at that time. In the last three years warty, erythematous, painless papillomatous lesions developed on the border of the leg ulcers (fig.1), with an histologic picture consistent with a diagnosis of low grade squamous cell carcinoma (fig.2, 3, 4). Staging showed nodular lesions of the right lung consisting of atypical squamous cells on fine needle biopsy. The patient refused any further investigation and was lost from follow up.
Paraffinoma is the result of a foreign body reaction to oily material injected deeply into the cutaneous and subcutaneous tissues for therapeutical, cosmetological or factitial purposes. After an interval of time between the injection and the appearance of skin lesions, the pathologic process goes through different stages: an inflammatory irregular plaque on the site of trauma followed by abscess formation, ulceration and fistulation after many years (1). From the histologic point of view such lesion is characterized by a sclerosing lipogranuloma evolution with classically "Swiss cheese" appearance.
Verrucous carcinoma (VC) is a low grade and well-differentiated squamous cell neoplasia. Four clinico-pathologic types are described according to the anatomic site of occurrence: i) skin: cutaneous verrucous carcinoma or papillomatosis cutis carcinoides; ii) feet: epithelioma cuniculatum; iii) anogenital: Buschke-Lowenstein tumor; iv) oral: oral florid papillomatosis (2). VC usually presents as a slow growing eso(endophytic mass with high infiltrative power to underlying soft tissue and bone and rarely metastatic potential. Increased evidence over the years have linked VC, mainly Buschke-Loweinstein tumor and epithelioma cuniculatum, to HPV infection with oncogenic potential (3,4). HPV infection can facilitate VC because of oncogene expression. Differential diagnosis of VC includes pseudoepitheliomatous hyperplasia and viral warts. VC can rarely develope in the site of chronic skin ulcers of varicous, traumatic, decubitus, burn or radiodermititis origin after a long period (20-34 years). In general spindle cell carcinoma is believed to be at increased risk of relapse and/or metastases once it developes from chronic cutaneous ulcer, with an overall survival rate of 52 and 34% at five and ten years follow-up respectively (5,6).
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[Dermatology] |
[Pathology] |
