scholarly journals A Clinico-pathological Study of Skin Tumours

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.

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.


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>


2021 ◽  
Vol 14 (8) ◽  
pp. e242276
Author(s):  
Ramani Thiagarajah ◽  
Pulivendhan Sellamuthu ◽  
Sarwinder Singh Bharmjit Singh ◽  
Rajesh Kumar Muniandy

Sarcomas are a group of rare malignant tumours of the connective tissues. They can occur in almost any location, but more frequently in the extremities. The occurrence of sarcomas in the head and neck region is less than 1%. We are presenting a case report of a very large cranial sarcoma. Gross total tumour excision was done with pedicle skin graft and titanium mesh cranioplasty. The excised tumour weighed approximately 1.1 kg. Histopathological examination showed primitive intermediate-sized tumour cells arranged in sheets, nests and cords with focal palisading. Postoperative MRI done 2 weeks post surgery showed no evidence of residual tumour.


2021 ◽  
Author(s):  
Lengbing Sun ◽  
Jiejie Lu ◽  
Ming Zhang ◽  
Xianxu Yang ◽  
Weiwei Wu ◽  
...  

Abstract Background: Skin cancers are the most frequent types of all malignant tumours with increasing incidence rates worldwide. Objectives: This study aimed to analyze the clinical–pathological characteristics of skin cancers in patients visited at the Department of Dermatology of the Fifth People's Hospital of Hainan Province from China during the last 12 years. Methods: The hospital database was searched for patients with skin cancers over a period of 12 years ( from January 1, 2009 to December 31, 2020) , and a retrospective review was conducted and a descriptive data analysis was undertaken on patients. Results: A total of 755 specimens of skin cancers were confirmed during this period, of which 696 (92.19%) were common skin cancers and of which 59(7.81%) were rare skin cancers. The incidence is on the rise year by year, with a marked decline in 2020. The common skin cancers were basal cell carcinoma (341, 48.99%), followed by squamous cell carcinoma (148 , 21.26%) and Bowen’s disease (109, 15.66%) . The range of age at the time of skin cancers was from 40 to 79 years (73.01% ). Males and females showed an almost similar incidence. The duration ranged from 7 days to 70 years, mainly occurred in 2 years( 53.30% ). The head, face and neck region were the most frequent location (452, 59.87% ), followed by extremity (107, 14.17% ) and trunk (87, 11.52% ). The accordance rates of clinical-pathological diagnosis in common skin cancers was about 43.14% , while that of rare skin cancers such as skin appendages was only 27.59% .Conclusions: Overall, head, face and neck region was the most common site for sun-related skin cancers in Hainan, China. BCC was the most common skin cancer followed by SCC and Bowen's disease. Moreover, skin cancers has a low coincidence rate of clinical-pathological diagnosis. Consequently, any suspicious lesion, for which the clinical diagnosis is uncertain, should be biopsied for histopathological examination to rule out malignancy.


2021 ◽  
pp. 1-2
Author(s):  
Surya Rao Rao Venkata Mahipathy ◽  
Alagar Raja Durairaj ◽  
Narayanamurthy Sundaramurthy ◽  
Anand Prasath Jayachandiran ◽  
Suresh Rajendran

Adenoid cystic carcinoma is a malignant neoplasm most commonly originating in the minor salivary glands of head and neck region. Among intra oral adenoid cystic carcinoma, buccal mucosa is one of the rarer sites. Here, we report a case of recurrent adenoid cystic carcinoma of the right buccal mucosa in a 33 year old female. As this is an uncommon site for adenoid cystic carcinoma, it should be considered as a differential diagnosis of mass of buccal mucosa. It is imperative that we identify such cases and plan for early surgical excision with adequate margins.


2021 ◽  
Vol 59 (1) ◽  
pp. 39-42
Author(s):  
А. Bekisheva ◽  
A. Makhneva ◽  
E. Satbaeva ◽  
G. Abyov ◽  
M. Remkulova

Ewing’s sarcoma is an aggressive tumor rarely found in the head and neck region and extremely rare in the nasal cavity or paranasal sinuses (2-3% of all Ewing’s sarcomas). Purpose: The article presents a clinical diagnostic case of nasal cavity Ewing’s sarcoma finally verified only by IHC test. Results: The presented clinical case describes Ewing’s sarcoma of the nasal cavity in a 14-year-old girl and presents the clinical picture, the results of MRI and CT examination of the sinuses, histopathological and IHC tests. Adequate diagnostical tools made it possible to establish a diagnosis. Timely determined treatment tactics, taking into account the tumor localization and possible postoperative complications, led to tumor remission. At present, the patient is under dynamic observation. Conclusion: The presented clinical case confirms that a primary nasal cavity Ewing’s sarcoma diagnostic largely depends on histopathological examination since visual diagnostic techniques do not provide reliable information on the tumor type.


2020 ◽  
Vol 9 (10) ◽  
pp. e1519108461
Author(s):  
Rani Iani Costa Gonçalo ◽  
Cristiane Kalinne Santos Medeiros ◽  
Humberto Pereira Chaves Neto ◽  
Janaina Lessa de Moraes dos Santos ◽  
Adriano Rocha Germano ◽  
...  

Background: Osteosarcoma is a malignant neoplasm that occurs most often in long bones, with the head and neck region being rarely affected, accounting for less than 1% of all cancers in this region. Objective: To report a rare case of a large-extension osteosarcoma with emphasis on its clinical and diagnostic aspects. Case presentation: A 43-year-old woman presenting an intraoral exophytic lesion with involvement of other maxillofacial structures, such as nostril, zygoma and orbit. Despite the initial clinical diagnosis of actinomycosis, an incisional biopsy confirmed the histopathological diagnosis of osteosarcoma, showing a wide morphological variety. Conclusion: This case highlights the importance of clinical and histopathological findings for the correct diagnosis of osteosarcoma. Moreover, it shows that, although surgical resection is the primary treatment for this neoplasia, depending on the extent of the tumor and its proximity to vital anatomical structures, the most appropriate conduct is not always feasible.


Author(s):  
Smita Singh ◽  
Jyoti Garg ◽  
Kusha Sharma ◽  
Kiran Agarwal

Intra-abdominal masses in children are usually malignant. Benign tumours at this location are not seen frequently. It is even rarer to find solitary myofibromas intra-abdominally as these tumours are known to have predilection for the head and neck region. We present an unusual case of solitary myofibroma with abdominal localisation in a six-year-old male child who presented with abdominal distension since six months. Computed Tomography (CT) abdomen revealed a complex solid-cystic mass extending from umbilicus to right iliac fossa and measuring 9×6×4 cm. Histopathological examination revealed a tumour displaying biphasic nodular pattern with the presence of lighter staining fascicles of mature myoid cells along with darker staining and more cellular areas of smaller primitive cells. On Immunohistochemistry (IHC), tumour cells were positive for vimentin and Smooth Muscle Actin (SMA) with variable reactivity for desmin while these were negative for CD34 and Anaplastic Lymphoma Kinase 1 (ALK). Based on the histopathological and immunohistochemical findings, final diagnosis of myofibroma was made. Recognition of these lesions is extremely challenging owing to their rare presentation intra-abdominally and also because of their close morphological overlap with other spindle cell tumours commonly found at this site. This case highlights the combined role played by histopathology and IHC in making a clear distinction between different entities. It is imperative for both clinicians and histopathologists to establish the correct diagnosis as excision of the solitary myofibroma is curative in most cases and offers better clinical course than the more commonly found malignant tumours at this site.


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