scholarly journals Clinicopathological study of skin tumours

Author(s):  
Vaidik Shrivastava ◽  
Ashwini Tangde ◽  
Anil Joshi ◽  
Rajan Bindu

Background: Skin cancers are relatively uncommon malignancies worldwide, but the incidence of skin cancers has progressively increased over the last few decades. The distinction between benign and malignant neoplasm are more difficult to define when they appear in skin than when found elsewhere and histopathological examination is frequently required to establish a definitive diagnosis. Diagnosis of any skin tumours can be done by correlating clinical features and histological features. The aim and objective were to study age-sex wise distribution, clinical presentation and histopathological spectrum of various skin tumours.Methods: This is a retrospective study of three years conducted in the Department of Pathology, Government Medical College, Aurangabad, India from December 2015 to December 2018. Specimens received from Department of Dermatology were fixed in formalin and after adequately processing the sections were stained routinely with H and E stain and properly evaluated for histopathological examination. This study includes tumors of epidermis along with melanogenic tumors and skin appendageal tumors. The data collected was tabulated, analysed and compared to other similar studies.Results: The study consists of 130 cases. The ratio of male to female was 1.24:1. Head and neck region (48.46%) was the most common site observed where skin lesions were present followed by extremities (37.69%). Most of the malignant tumours were presented with non-healing ulcers (30.76%) and Noduloulcerative lesions (20.33%). Out of 130 cases, 83 (63.84%) were benign whereas 47 (36.15%) were malignant tumour. According to WHO classification, keratinocytic tumour 55 (42.30%) was the most common tumour type in the present study. Skin adnexal tumours and melanocytic tumours were observed in 54 (41.53%) and 21 (16.15%) respectively.Conclusions: The skin is a complex organ. Because of complexity of skin, a wide range of diseases can develop from the skin. The majority of benign neoplasms are from skin adnexal group whereas most common malignant neoplasm were from keratinocytic group. Skin adnexal tumors can occur anywhere in the body, however head and neck region constitute the most common site. Skin adnexal tumours are clinically often misdiagnosed, so histopathological examination remains gold standard for their correct diagnosis and for their differentiation between benign and malignant neoplasm.

Author(s):  
P. Rekha ◽  
Vindu Srivastava

Skin cancers are relatively uncommon malignancies worldwide, but the incidence of skin cancers has progressively increased over the last few decades. The distinction between benign and malignant neoplasm are more difficult to define when they appear in skin than when found elsewhere and histopathological examination is frequently required to establish a definitive diagnosis.  The present study was the incidence of various benign and malignant tumours of skin and its adnexa. Histopathological examination remains the gold standard in diagnosing most skin  tumours. Thus diagnosis of any skin tumor can be done by correlating clinical features and histological features, which in turn can be supported by histochemistry, immunohistochemistry and electron microscopy. Most of the skin tumours were Nodular lesions (34.3%), followed by papular lesions (28.4%) and by ulcerated lesions (9.8%). Malignant tumours commonly presented as ulcerated lesions. Head and neck region was the most common site of occurrence followed by extremities and trunk. Keratinocytic (31.4%) tumours were the commonest group among all skin tumours.


2019 ◽  
Vol 10 (1) ◽  
pp. 48-53
Author(s):  
Mohammad Sowkat Hossain ◽  
S M Mahbubul Alam ◽  
Sk Md Jaynul Islam ◽  
Wasim Selimul Haque ◽  
Shamoli Yasmin

Background: Undifferentiated tumours in the head and neck region are not uncommon. They can arise from different sites like in mucosa as well as in salivary glands, soft tissues or lymph nodes. Histopathological examination plays a central role in the diagnosis but difficulties arise with some tumours which are poorlydifferentiated due to their high inter- and intra-observer variability. In those cases, immunohistochemistry has greatly assisted to diagnose the tumours that cannot be accurately identified using routine histopathological procedures. The correct histopathological diagnosis is essential especially in case of malignant tumourwhere subsequent specific therapy is required. The aim of this study was to determine the role of immunohistochemistry for diagnosing undifferentiated malignancy in the head and neck region. Methods: This cross-sectional study was conducted during July 2014 to June 2015. A total of 35 Bangladeshi patient’s specimens of head and neck swelling were collected from two renowned laboratories in Dhaka city.These cases were diagnosed as undifferentiated tumour in histopathological examination.Standard protocol was followed for immunohistochemistry.Then primary immunohistochemical panel which included the markers for Epithelial CK (AE1/AE3),mesenchymal marker (Vimentin) and lymphoid marker (LCA) were used.The cases which were not resolved by primary immunohistochemistry panel, the second panel was applied for further sub classification (Desmin, Chromogranin, CK20, CEA, CD20, CD30, HMB45, NSE). Based on interpretation of immunohistochemical findings final diagnoses were made.Data analysis was performed using the Statistical Package for the Social Sciences for Windows version 22.0 (SPSS, Chicago, Illinois, USA). Results: A total of 35 undifferentiated tumorsof head-neck region were studied.The mean age was 46.3±17.6 years and male to female ratio was 4.8:1. The majority 13 (37.1%) patient had cervical lymphadenopathy, 11 (31.4%) had neck mass and 4(11.4%) had in nasal/sinonasal mass.Regarding histopathologicalcell types, round cell was 21 (60.0%), spindle cell 6 (17.1%), pleomorphic cells 6(17.1%) and epithelioid cells 2(5.7%). In initial histopathological examination, majority 25(71.4%) were undifferentiated malignant neoplasm, 8(22.8%) were metastatic undifferentiated carcinoma, 1(2.9%) was pleomorphic sarcoma and the remaining 1(2.9%) had malignant adnexal tumour. By application of immunohistochemistry, most (33, 94.3%) of the cases were resolved and the two cases remained unresolved. Among the resolved cases majority (15, 45.5%) were lymphoma, 4(12.1%) were metastatic carcinoma, 3(9.1%) were Ewing’s sarcoma and malignant melanoma were found in 3(9.1%) cases. Conclusion: This study supports that the immunohistochemical technique has a fundamental role in the investigation of undifferentiated tumour origin, to determine the correct guidance for treatment and improving the prognosis for head and neck tumour patients. Birdem Med J 2020; 10(1): 48-53


Author(s):  
C. J. Timna ◽  
D. Chandrika

<p class="abstract">Benign calcifying epithelioma of Malherbe or pilomatricoma is rare benign skin tumours, typically seen in head and neck region. This is supposed to arise from hair follicle matrix cells. Though head and neck is the commonest area involved by this tumour, only 4.5% cases have been reported in the pinna. Neck is most commonly involved followed by cheek, scalp, pre auricular and peri orbital areas. Here we report a case of pilomatricoma over medial surface of pinna in a 20 years old female. She had the swelling which was gradually increasing for the past 5 years. Histopathological examination following excision biopsy confirmed the diagnosis.</p><p class="abstract"> </p>


2014 ◽  
Vol 4 (2) ◽  
pp. 118-123
Author(s):  
Jagdish Vishnu Tupkari ◽  
Tabita Joy Chettiakandy ◽  
Dimple Padawe ◽  
Keshav Kumar ◽  
Manisha Sardar ◽  
...  

ABSTRACT Adult fibrosarcoma (FS), defined by the World Health Organization as ‘malignant neoplasm composed of fibroblasts with variable collagen production and, in classical cases, a ‘herringbone’ architecture’, is a very rare soft tissue sarcoma. The earlier literature revealed that the adult fibrosarcoma was the most commonly occurring lesion, however the incidence of which has declined dramatically over the past several decades. This is due to evolution in the classification of soft tissue tumors, recognition of its subtypes and increased understanding of the many other mesenchymal and nonmesenchymal tumors. Sarcomas are the rare group of malignancies which accounts for less than 1% of all the body sarcomas of which 5 to 15% occurs in head and neck region. It involves deep soft tissues of extremities, trunk, head and neck. Among the head and neck region, intraoral adult fibrosarcomas are very rare without any sex predilection. A case of primary soft tissue FS in posterior mandible of an 13-year-old female patient is documented here, which will be an addition to the cases reported earlier in the literatures. How to cite this article Tupkari JV, Chettiakandy TJ, Padawe D, kumar k, Sardar M, Gupta N. Intraoral Soft Tissue Fibrosarcoma: A Case Report and Review. J Contemp Dent 2014;4(2):118-123.


Author(s):  
Shalini Jain ◽  
Sahil Maingi ◽  
Ancy S. Sofia ◽  
A. K. Rai

<p class="abstract">Lipoma is a benign mesenchymal tumor with a thirteen percent incidence in head and neck region. Posterior triangle is the most common location while anterior neck lipoma is a rare one. Giant lipomas &gt;10 cm have been reported in different parts of the body but rarely in the anterior neck. Surgical excision remains the treatment of choice. We here report a case of giant anterior neck lipoma in a 50 year old male managed surgically.</p>


2020 ◽  

Introduction: Adenoid cystic carcinoma is a rare salivary gland malignancy that can occur in any part of the body, its clinicopathologic features are scarcely reported in locoregional literature. Therefore, in this study we aimed to evaluate the clinicopathologic features of adenoid cystic carcinoma in our population and to determine the association of age and site of its occurrence with histologic pattern and perineural invasion. Methods: We retrospectively analyzed 30 cases of adenoid cystic carcinoma that underwent surgical resections or biopsies from March 2009 to February 2020 at Liaquat National Hospital and Medical College, Karachi. Clinical and histopathological parameters including age, site, histological pattern and perineural invasion were determined and association between different parameters was analyzed. Results: Mean age of the patients was 30 + 16.1 years. Cribriform pattern was most common histologic pattern (63.3%) while head and neck region was the most common site of occurrence (83.3%). Perineural invasion which is one of the most important prognostic factors in adenoid cystic carcinoma was present in approximately half of the patients (46.7%). No significant association of age and site was found with histologic pattern and perineural invasion. Conclusion: Adenoid cystic carcinoma is a rare malignancy most commonly occurring in head and neck region with a high frequency of perineural invasion. No significant difference of histologic pattern and histologic prognostic parameter like perineural invasion was noted at different ages and different sites in our study.


2007 ◽  
Vol 121 (10) ◽  
pp. 979-985 ◽  
Author(s):  
Kishore C Prasad ◽  
S Sreedharan ◽  
Y Chakravarthy ◽  
Sampath C Prasad

Objective: With improvement in economic and social conditions and the use of effective anti-tubercular therapy, the developed nations, and most developing nations, have enjoyed a decline in tuberculosis for several decades. It is now seen that extra-pulmonary presentations form a major proportion of new cases, especially since the advent of the acquired immunodeficiency syndrome epidemic. Therefore, it is important that otolaryngologists are aware of tuberculosis in the head and neck region and its varied manifestations. We report the increased incidence of isolated head and neck tuberculosis, its various presentations and clinical manifestations over a 10-year period.Materials and methods: A 10-year (1995–2004), retrospective study was undertaken by the department of otolaryngology and head and neck surgery, Kasturba Medical College, and its allied hospitals, Mangalore, South India, involving a group of 165 patients with head and neck tuberculosis. Each patient underwent a detailed clinical examination and a battery of investigations. Most patients were treated with anti-tubercular therapy alone; others required surgical intervention followed by Anti-tubercular therapy (ATT). In addition, those with human immunodeficiency virus infection or malignancy were treated with anti-retroviral therapy and radiotherapy, respectively.Results: Of the 165 cases, 121 (73.3 per cent) had isolated tubercular lymphadenitis, 24 (14.5 per cent) had laryngeal tuberculosis, four (2.4 per cent) had tubercular otitis media, three (1.8 per cent) had tuberculosis of the cervical spine, three (1.8 per cent) had tuberculosis of the parotid, eight (5 per cent) had tuberculosis of the oral cavity, one had tuberculosis of the temporo-mandibular joint and one had tuberculosis of the nose. Fine needle aspiration cytology was highly effective in the diagnosis of tubercular lymphadenitis (92 per cent) but not so for other sites. The purified protein derivative (PPD) test was positive in only 20 per cent of cases. Pus for culture and sensitivity was positive only in caries of the spine and mandibular tuberculosis. Excision biopsy and histopathological examination were required to make a diagnosis in tuberculosis of the oral and nasal cavities, salivary glands, ear, temporo-mandibular joint, and mandible. There were 40 cases (24.2 per cent) with coexisting pulmonary tuberculosis and five cases (3 per cent) with coexisting malignancy. Of the 65 patients who were tested, 30 per cent were found to have coexisting human immunodeficiency virus infection.Conclusion: In addition to cervical lymphadenitis, tuberculosis in the head and neck region can produce isolated disease in the oral cavity, ear, salivary glands, temporo-mandibular joint, nose and larynx. Seventy-five per cent of our head and neck tuberculosis patients did not have pulmonary involvement. Fine needle aspiration cytology was highly effective in the diagnosis of nodal tuberculosis, but histopathological examination was required to make the diagnosis in other head and neck sites. The PPD test was not effective as a diagnostic tool. If the otolaryngologist maintains a high index of suspicion, an early diagnosis can be made with the help of simple investigations. Successful outcome depends upon appropriate chemotherapy and timely surgical intervention when necessary.


2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Abdulvahap Akyigit ◽  
Hadice Akyol ◽  
Oner Sakallioglu ◽  
Cahit Polat ◽  
Erol Keles ◽  
...  

Rosai-Dorfman disease is a rarely seen disease with unknown etiology. Extranodal involvement is most commonly seen in the head and neck region. Histopathologically, it is characterized by histiocytic cell proliferation. This paper presents a case of a 15-year-old male patient who presented with nasal obstruction and was surgically treated for a mass filling in the left nasal meatus that was diagnosed to be Rosai-Dorfman disease by histopathological examination.


1989 ◽  
Vol 103 (2) ◽  
pp. 216-218 ◽  
Author(s):  
M. B. Jordan ◽  
J. V. Soames

AbstractFibrous histiocytoma is uncommon in the head and neck region and rare in the larynx. Its behaviour is unpredictable.A case is reported in a 54-year-old male which was treated conservatively initially and which recurred several times over a seven year period. During that time the appearances of the lesion changed from those of a densely collagenous, cytologically benign tumour to those of a richly cellular and potentially malignant neoplasm. Laryngectomy was eventually undertaken.


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