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Malignant rhabdoid skin tumor: an uncommon primary skin neoplasm. Ultrastructural and immunohistochemical analysis.

Rhabdomyosarcomatoid renal tumors were initially described as a subset of tumors in the National Wilms Tumor Study that had light microscopic features similar to rhabdomyosarcomas. Subsequent studies failed to reveal evidence of muscle differentiation, thus the genesis of the term "rhabdoid" tumor. Such renal tumors are rapidly lethal. Recent reports suggest the occurrence of tumors with similar morphology in other anatomic sites. We wish to report a primary malignant rhabdoid tumor of the facial skin with detailed immunohistochemical and ultrastructural studies. Vimentin was expressed in the tumor cells, but there was no immunoreactivity for cytokeratins, neurofilaments, muscle actin, synaptophysin, S-100, melanoma antigen HMB-45, epithelial membrane antigen, neuron specific enolase, Leu-7, leucocyte common antigen or lysozyme/alpha-1-antitrypsin. Ultrastructure revealed typical whorled cytoplasmic aggregates of intermediate filaments. These studies along with a literature review reveal the heterogeneous immunohistochemical profiles of these tumors with common morphologic features. While the histogenesis of these tumors remain uncertain, it is necessary to recognize that these aggressive neoplasms may occur primarily in the skin.

Forehead↗

[The role of proteolytic enzymes in skin neoplasm progression and development of metastasis].

Proteases are reported to play an essential role in the proliferative, invasive, and metastatic potential of malignant tumor cells. Metastasis is characterized by a complex series of interactions between tumor cells and their environment. Tumor expansion and invasion are associated with the destruction of normal tissues around the tumor by a variety of classes of tumor and host-derived extracelullar matrix-degrading proteinases. Increased levels of the major lysosomal proteinases cathespin B, D, L, metalloproteinases and plasminogen activators, are correlated with tumor cell invasion and metastasis in human melanoma and other skin tumors, breast and colorectal cancer.

Animals↗

[Skin neoplasms of the face--diagnosis and possibilities of surgical treatment].

Experiences are presented based on the observation and treatment by surgical methods of 360 patients with facial cutaneous carcinoma in a period of 16 years. The group comprised 57% men and 43% women. Over half the patients had the lesions situated on the nose. In the remaining cases the tumour developed on the cheek (19%), temple (11%), eyelids (6%), forehead (5%) and skin of the lips (3%). Particular therapeutic difficulties were encountered in cases of lesions situated in the medial angle of the palpebral fissure. In 3 cases extensive craniofacial resection with orbitectomy was done for advanced malignant lesions. In 71% of cases basal cell carcinoma was the cause, and in 29% spinocellular carcinoma was diagnosed. Metastases to regional lymph nodes removed during the operation were demonstrated in 16 cases, exclusively caused by spinocellular carcinoma. The problem of surgical safety margin and the main problems of reconstructive procedures in surgical treatment of facial cutaneous carcinoma are discussed.

Adult↗

[Comparison of the effect of different carcinogens on the skin of rats].

Solution of N-methyl-N-nitrosourea (MNU), diazoacetic ester (DAAE), N-methyl-N-nitro-N-nitrosoguanidine (MNNG), N-methyl-N,N'-dinitroguanidine, 4-dimethylaminoazobenzene (DAB), o-aminoazotoluene or 7,12-dimethylbenz(a)anthracene (DMBA) were applied to rat skin. Neoplasms (skin tumors) were found only in the experiments with MNU, DAAE, MNNG, DAB and DMBA, MNU, MNNG, DAB and DMBA induced tumours in the sites of skin painting. In experiments with DAAE distant skin neoplasms developed as well. Possible mechanisms of action of these compounds are discussed.

9,10-Dimethyl-1,2-benzanthracene↗

Neoplasms in skin and subcutis over the breast, simulating breast neoplasms: case reports and literature review.

Twenty cases of neoplasms in skin and subcutaneous tissue over the breast were reviewed. There were 17 women, from 15 to 70 years of age, and three men, from 25 to 66 years of age. Among the benign skin neoplasms, superficial leiomyoma, granular cell tumor, and eccrine acrospiroma were misdiagnosed clinically as primary breast carcinoma. Among the malignant neoplasms in subcutaneous tissue, there were three metastatic malignant melanomas, one metastatic epidermoid bronchogenic carcinoma, and two malignant lymphomas. It is interesting that four of these six patients had no prior history of malignant lesion, the subcutaneous nodule presenting as the first manifestation of an occult primary. It is concluded that histological diagnosis of such tumors may lead to avoidance of unnecessary radical surgery.

Adenoma, Sweat Gland↗

[Myoepithelial neoplasms of skin and soft tissues].

Myoepithelial neoplasms of skin and soft tissues comprise cutaneous mixed tumor (chondroid syringoma), mixed tumor of subcutaneous and deep soft tissues, myoepithelioma and rare malignant myoepithelioma (myoepithelial carcinoma). Myoepithelial tumors of skin and soft tissues are characterized by an extreme clinicopathological heterogeneity as in other anatomic locations. The neoplasms arise in childhood as well as in adults and are composed of epithelioid, histiocytoid, spindled, plasmocytoid and/or clear tumour cells in varying combinations, and are set in a myxoid or hyalinised intercellular matrix. Immunohistochemically, neoplastic cells stain positively for epithelial markers (pancytokeratin and/or epithelial membrane antigen), and often for S 100 protein. More rarely muscle actin, glial fibrillary acid protein, calponin, and p63 are expressed, whereas desmin is usually negative. The presence of at least moderate cytological atypia is associated with a significant risk for aggressive behavior and propensity for metastasis.

Adult↗

Skin adnexal neoplasm closely resembling adenomatoid tumor: a unique occurrence.

We describe a primary skin neoplasm located in the left chest wall that closely resembled adenomatoid tumor of male and female genital tract. It occurred in a 52-year-old woman who had undergone a left quadrantectomy with regional lymphadenectomy for invasive ductal carcinoma of the breast 7 years previously. The tumor involved the dermis and subcutaneous tissue and measured 0.7 cm in greatest diameter. Immunohistochemical evaluation showed strong positivity for cytokeratin pool and negativity for CD31, calretinin, WT-180, and for estrogen and progesterone receptors. We are unaware of a previous description of this morphologic pattern in a primary skin tumor, which we have interpreted as of skin adnexal and specifically of eccrine sweat gland origin.

Adenomatoid Tumor↗

[Perivascular neoplasms of skin and soft tissues. A review].

Perivascular neoplasms of skin and soft tissues comprise a group of benign and malignant mesenchymal neoplasms showing a perivascular myogenic differentiation. Whereas glomus tumour including its variants represents a clearly defined clinicopathological entity, the whole concept of haemangiopericytoma has been questioned in the last years, and no clear diagnostic criteria are established at the moment. Myopericytomas and myofibromas represent a morphological spectrum of perivascular spindle-shaped lesions. Infantile myofibroma/infantile myofibromatosis and solitary myofibroma of adults are characterized by a biphasic growth of mature, spindled, myofibroblastic cells and smaller, immature, mesenchymal cells associated with numerous haemangiopericytoma-like vessels. Benign and rare malignant myopericytomas of skin and soft tissues are characterized by a concentric, perivascular growth of plump spindled and round tumour cells staining positively for muscle actin, alpha-smooth muscle actin and more rarely for desmin. PEComas represent an enigmatic family of neoplasms composed of perivascular epithelioid, clear, and spindled tumour cells characterized by a coexpression of melanocytic and myogenic markers.

Diagnosis, Differential↗

Clear cell carcinoma of the skin. A variant of the squamous cell carcinoma that simulates sebaceous carcinoma.

Certain clear-cell carcinomas of the skin observed in elderly caucasian men with a history of excessive sun exposure and multiple skin neoplasms may be mistaken for sebaceous carcinomas or other cutaneous clear-cell tumors. These tumors are believed to be variants of squamous cell carcinoma undergoing extensive hydropic change which results in the clear-cell appearance. They are classified into three histologic types. Type I and type III tumors are either primary or recurrent squamous-cell carcinomas. The histogenesis of type II tumors is uncertain but they may represent recurrent metastatic tumors from the previously excised, adjacent epidermal squamous-cell carcinomas; however, the possibility that they are primary adnexal tumors of undetermined histogenesis remains to be determined. Various techniques of staining, as well as differences in histologic appearance, assist in the differential diagnosis of these and other cutaneous clear-cell neoplasms.

Adenocarcinoma↗

Skin adnexal neoplasms--part 1: an approach to tumours of the pilosebaceous unit.

Skin adnexal neoplasms comprise a wide spectrum of benign and malignant tumours that exhibit morphological differentiation towards one or more types of adnexal structures found in normal skin. Most adnexal neoplasms are relatively uncommonly encountered in routine practice, and pathologists can recognise a limited number of frequently encountered tumours. In this review, the first of two, the normal histology of the skin adnexal structures is reviewed, and the histological features of selected but important benign and malignant tumours and tumour-like lesions of pilosebaceous origin discussed, with emphasis on the diagnostic approach and pitfalls in histological diagnosis.

Humans↗

Reticular and plexiform perineurioma: clinicopathological and immunohistochemical analysis of two cases and review of perineurial neoplasms of skin and soft tissues.

Perineurioma represents a recently described and relatively rare neoplasm in the spectrum of benign peripheral nerve sheath tumours composed of perineurial cells staining immunohistochemically positive for epithelial membrane antigen (EMA). In addition to intraneural, extraneural and sclerosing perineurioma, rare variants of perineurioma may occur, and their knowledge is important in the differential diagnosis of mesenchymal tumours of different lines of differentiation and clinically more aggressive neoplasms. We present a case of deep-seated reticular perineurioma arising on the upper arm of a 34-year-old female and a case of a dermal plexiform perineurioma arising on the lower lip of a 60-year-old female. The diagnosis was confirmed in both cases immunohistochemically; neoplastic cells stained positively for EMA and for the newly described perineurial markers, claudin-1 and glut-1. The morphological spectrum and the differential diagnosis of perineurial neoplasms of skin and soft tissues are discussed.

Adult↗

Carcinogenic potential of o-nitrotoluene and p-nitrotoluene.

The potential of o-nitrotoluene and p-nitrotoluene to cause cancer in mammalian species was studied in male and female F344/N rats and B6C3F1 mice. These chemicals are on the EPA list of high production chemicals and there is potential for human exposure (High Production Volume Chemical List (2000) http://oaspub.cpa.gov/opptintr/chemrtk/volchall.htm.). o-Nitrotoluene, administered in the feed for up to 2 years, caused clear evidence for cancer at multiple sites in rats and mice. Male rats, receiving o-nitrotoluene in the feed ( approximately 0, 25, 50, or 90 mg/kg per day), developed treatment-related mesotheliomas, subcutaneous skin neoplasms, mammary gland fibroadenomas, and liver neoplasms. By 2 years, mesotheliomas, skin, liver, mammary gland and liver tumors also occurred in 'stop-study' male rats that received o-nitrotoluene at 125 or 315 mg/kg per day for only the first 3 months of study. These 'stop-studies' showed that the critical events leading to tumor formation occurred after 3 months of dosing, and these events were irreversible and eventually led to cancer at multiple sites. o-Nitrotoluene given in the feed to female rats (approximately 0, 30, 60, or 100 mg/kg per day) and to male and female mice (approximately 0, 150, 320, or 700 mg/kg per day) also caused a carcinogenic response. In female rats, treatment-related subcutaneous skin neoplasms and mammary gland fibroadenomas occurred. Hemangiosarcomas and carcinomas of the large intestine (cecum) were seen in treated male and female mice. In contrast to o-nitrotoluene, p-nitrotoluene given in the feed over approximately the same exposure levels caused only equivocal evidence of carcinogenic activity in male rats (subcutaneous skin neoplasms); some evidence of carcinogenic activity in female rats (clitoral gland neoplasms); equivocal evidence of carcinogenic activity in male mice (lung neoplasms); and no evidence of carcinogenic activity in female mice. Differences in the o-nitrotoluene and p-nitrotoluene carcinogenic activity may be due to differences in the metabolism of the parent compound to carcinogenic metabolites.

Animals↗