Ebrahim Esmati; Mojtaba Vand Rajabpour; Mohammad Shirkhoda; Vahid Soleimani; Maryam Garousi
Abstract
Trichilemmal carcinoma is a rare tumor of the outer sheath cells of hair follicles. These tumors occur on the sun-exposed skin of the elderly in the majority of cases. The gross tumor demonstrates exophytic, polypoid, ulcerative, or nodular lesions with or without bleeding. Histopathologically, it is ...
Read More
Trichilemmal carcinoma is a rare tumor of the outer sheath cells of hair follicles. These tumors occur on the sun-exposed skin of the elderly in the majority of cases. The gross tumor demonstrates exophytic, polypoid, ulcerative, or nodular lesions with or without bleeding. Histopathologically, it is characterized by an anastomosing trabecular, diffuse, or lobular growth pattern with clear keratinization. A critical differential diagnosis is squamous cell carcinoma (SCC), where the prognosis of trichilemmal carcinoma is far better than SCC. Surgery is a significant and effective treatment for trichilemmal carcinoma cases, and recurrence after complete surgical resection with a negative margin is uncommon. Trichilemmal carcinoma is considered a low-grade tumor with low metastatic potential. This paper reports a 48-year-old Iranian male with trichilemmal carcinoma of the scalp treated with surgery, having no recurrence after three years of follow-up. The role of other treatment modalities like radiation, local therapy, and systemic therapy are also discussed.
Iffat Hassan; Peerzada Sajad; Syed Mubashir
Volume 17, Issue 3 , 2014, , Pages 101-103
Abstract
Background: Bowen’s disease is a form of intraepidermal squamous cell carcinoma (SCC) characterised by a persistent, non-elevated, red, scaly or crusted plaque with a small potentialfor invasive malignancy. Most cases of typical Bowen’s disease in the white population are found ...
Read More
Background: Bowen’s disease is a form of intraepidermal squamous cell carcinoma (SCC) characterised by a persistent, non-elevated, red, scaly or crusted plaque with a small potentialfor invasive malignancy. Most cases of typical Bowen’s disease in the white population are found on the lower legs of the elderly women. However, in this part of the world, i.e. Kashmir, the mostcommon site is thighs followed by the lower abdomen. A range of treatment options are available for it including cryotherapy, curettage and cautery, photodynamic therapy, laser destruction,surgical excision, 5-fluorouracil cream, imiquimod cream, and radiotherapy. The aim of this study was to evaluate the efficacy of surgical excision in Bowen’s disease.Method: All the patients with biopsy proven Bowen’s disease were included for the study. A detailedhistory was taken for each patient including the history of medical treatment for Bowen’s disease. Wide surgical excision (including either fusiform excision, W-plasty, or Z-plasty) was performed in each patient and the patients were then followed up for any recurrence. No sign of renewed disease activity at 6 months follow-up was taken as cure. All patients are intended to be followed up for 5 years.Result: Ten out of 12 patients reported the use of topical imiquimod cream but complained of the progression of lesions. Surgical excision was performed in 12 patients. All the patients are currently under regular follow-up. Except for secondary infection and wound dehiscence in one patient, all the patients are in good condition with no signs of recurrence.Conclusion: Although it was a preliminary study, we recommend surgical excision in treatment of Bowen’s disease due to low recurrence rate.
Anvari Kazem; Hosseini Sare; Toussi Mehdi Seilanian; Afifi Saeede
Volume 17, Issue 1 , 2014, , Pages 27-30
Abstract
Background: Non melanoma skin cancer (NMSC) is the most common cancer worldwide. In most cases, the general outlook is excellent; however, local recurrence or metastasis can occur. In this study, we investigated possible tumor and host characteristics affecting the treatment outcome in our department ...
Read More
Background: Non melanoma skin cancer (NMSC) is the most common cancer worldwide. In most cases, the general outlook is excellent; however, local recurrence or metastasis can occur. In this study, we investigated possible tumor and host characteristics affecting the treatment outcome in our department of radiation oncology.Method: We retrospectively studied cases with non melanoma skin cancer (NMSC) who were consecutively referred to department of radiation oncology in Omid and Ghaem Hospitals between 1997 and 2007. The effect of the patients’ characteristics (age, sex), tumor characteristics (histology, size, location), and treatment modalities on prognosis were evaluated.Result: We studies 426 patients with a median age of 65 (range: 14 to 102) and a male to female ratio of 1.4:1. Pathologic review showed 72% of the patients had basal cell carcinoma (BCC) and 28% had squamous cell carcinoma (SCC) with a 5-year event free survival of 87±3% and 67±8%, respectively (p < 0.001). The local recurrence rate was higher in cases with scalp lesions (35%). The patients who underwent combined modality treatment experienced significantly more instances of failure as compared to those receiving radiotherapy alone (5-year event free survival of 81±6% vs. 84±6%, p=0.04) which reflects the higher number of cases with adverse features including larger lesions and/or a positive surgical margin in this group. Sex, age, and multifocality were not significant predictors of prognosis.Conclusion: SCC histology and scalp location were predictive of higher rates of treatment failure in patients with NMSC. There was no correlation between age, sex, multifocality and overall outcome. The higher rate of recurrence in cases receiving combined modality treatment is most probably due to the high number of tumors with adverse prognostic features in these cases.
Mostafa Mirshams Shahshahani; Mahmood Razzaghi; Amir Houshang Ehsani; Pedram Normohamadpour; Zahra Naraghi; Kambiz Kamyab; Sara Sabouri Rad
Volume 14, Issue 1 , 2011, , Pages 1-5
Abstract
Background: Surgery is the most frequent treatment modality for basal cell carcinoma but in spite of its high cure rate, the frequency of incomplete excision varies widely (0.7-50%) among dermatologic centers. Our case series was designed to determine the frequency of incompletely excised basal cell ...
Read More
Background: Surgery is the most frequent treatment modality for basal cell carcinoma but in spite of its high cure rate, the frequency of incomplete excision varies widely (0.7-50%) among dermatologic centers. Our case series was designed to determine the frequency of incompletely excised basal cell carcinoma and the related risk factors. Methods: A total of 1424 basal cell carcinoma (1040 patients) lesions which were excised in Razi Dermatology Hospital of Tehran from 2006 to 2008 were evaluated in this case series and their findings were analyzed with SPSS software. Results: Incidence of incomplete excision was 12% and involvement of the deep margin was observed in 54% of these lesions. Factors related to incomplete excision were infiltrative, morpheic and micronodular subtypes, lesions larger than 20 mm, those repaired by skin grafts and those that received local anesthesia. There was no statistically significant difference in age, sex, site of lesions and childhood history of radiotherapy for tinea capitis. Conclusion: Recognizing the risk factors related to incomplete excision of BCCs would help us consider a wider excision margin for high risk tumors.