Mnogie raki podstawnokomórkowe na podłożu znamienia łojowego

Nevus sebaceous (NS) is a benign hair follicle neoplasm seen approximately 1.3% of the population, typically affecting the scalp, neck or face. NS presents as a yellowish patch or plaque, but may develop papillomatous appearance especially after puberty. Basal cell carcinoma (BCC) is a rare result of NS. However it is the most common malignant neoplasm in NS. However, in general, the most common neoplasm is trichoblastoma [1–3].
A 27-year-old male patient was admitted to the outpatient clinic with complaint of black swellings on his scalp. It was learned that nevus was congenital and the swellings developed for approximately 2 years. Dermatological examination revealed 3 pieces greyish black papules between 2 mm and 1 cm in size on surface of a 6 cm2 NS (fig. 1). In the dermoscopic examination of the lesion, branched and linear veins and bluish structureless areas including gray-white streak-like structures (lower left); bluish-white structureless area adjacent grayish papillomatous structure (middle) and gray-blue ovoid nests with thin branched veins and maple-like structures (upper right) were observed (fig. 2). On histopathological examination, tumor islets consisted of pigmented basaloid cells were observed. Increased staining was observed in neoplastic cells with Ki-67 proliferation index, BER-EP4 and P53 (fig. 3). As a result of total excision of the lesion, with histopathologic and immunhistochemical findings, three BCC-compatible tumors and NS were observed. Surgical margins of tumors were intact. Evaluation of margins was done by vertical sectioning. Multiple BCCs arising on NS are extremely rare and we present this rare case with clinical histopathological and immunohistochemical features.
Nevus sebaceous is a rare congenital abnormality that can cause cosmetic deformation, alopecia or malignant transformation. If it is associated with syndromic features such as central nervous system abnormalities, mental retardation, oculocardiac defects or skeletal abnormalities, this is called Schimmelpenning-Feuerstein-Mims syndrome. In adolescence, hormonal changes cause proliferation and hyperplasia of the lesion and cause more verrucous appearance which can be quite large. Later in life, the lesions may develop benign or malignant appendiageal tumors [1, 3–5]. It has been suggested that the lifetime risk for the malignant change of SN ranges between 5% and 22%. There has been a lot of discussion about the true incidence of BCC that occurs in...


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