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Malignant eccrine poroma in an elderly African-American woman.

BACKGROUND: Eccrine porocarcinoma is a rare, slow-growing malignant tumor arising from the eccrine sweat gland. OBJECTIVE: We present a case of eccrine porocarcinoma of the ear in an elderly African-American woman. Cases of eccrine porocarcinoma have been reported in the literature occurring in facial, extremity, scalp, and genital sites and primarily in Caucasian patients. Rarely are cases described in African-American patients or on the ear. METHODS: We describe the history of the lesion, discuss the current cancer statistics for skin cancer in African Americans, and histology and treatment choices are compared with previously reported cases. RESULTS: We present a case of malignant eccrine poroma of the ear in a 71 year old African-American woman. The tumor was completely excised by Mohs surgery. Transposition flap repair of the Mohs surgical defect was performed. CONCLUSIONS: While African Americans are at low risk of developing skin cancers, it is important to remember that skin cancers can affect patients of any ethnicity and skin tone. Treatment regimens for skin cancers in African-American patients must be chosen appropriately by site of tumor, size of tumor and extent of disease as would be expected for any skin cancer.

Acrospiroma↗

Evaluation of the VX2 rabbit auricle carcinoma as a model for head and neck cancer in humans.

INTRODUCTION: This study investigates whether the VX2 carcinoma cell line, transplanted into the rabbit auricle, can be used as a head and neck cancer model. The biologic behaviour of this model is evaluated, comparing tumour transplantation with either tissue pieces or cell suspensions. MATERIAL: Thirty-six adult NZW rabbits received s.c. injections of VX2-suspensions (Group S) and 11 rabbits received solid VX2-pieces (Group P) into both auricles. METHODS: In Group S, 16 rabbits were sacrificed at various days before (S1) and 15 after (S2) the 28th day following transplantation. In the other five rabbits transplantation failed. Animals from Group P were sacrificed every 2 weeks after the 28th day. At autopsy the size of the primary tumours and of lymph node, lung and other metastases were assessed. If transplantation failed, the maximal tumour size and the time at which regression took place were recorded. Exponential trend lines were used to create growth curves of metastases. Differences between groups were evaluated with the chi2 test, correlations between parameters with Kendall's tau. RESULTS: The tumour take-rate in Groups S and P was 78% and 59% respectively. The maximal size and time at which regression occurred was significantly different, amounting to 83 +/- 7 mm2 at 10.4 +/- 1.6 days (Group S) and 243 +/- 30 mm2 at 20.9 +/- 2.0 days (Group P), respectively. Development of lymph node metastases was not different. In Groups P and S2, over 90% of the necks contained lymph node metastases. There was a higher incidence of lung metastases in Group S2 when compared to Group P (47% vs. 14%) but it was not statistically significant. A significant correlation (p<0.05) between weight loss and the size of lung metastases was found. CONCLUSION: Transplantation of the VX2-tumour with cell suspensions produces a useful head and neck cancer model for locoregional disease in which anti-tumour regimens against both the primary and lymph node metastases can be tested. Transplantation with tumour pieces is not advised as the take-rate is low and spontaneous remissions occur at a late stage.

Animals↗

[Digital subtraction angiography of cancerous changes in the ear, nose and throat area].

Intravenous and intra-arterial digital subtraction angiography is able to demonstrate hypervascular tumours in the ear, nose and throat territory. Direct puncture of a venous bypass used for intra-arterial chemotherapy, within the external carotid artery territory, is devoid of risk and can be used for assessing the accessibility of the tumour. Lesions of low vascularity can only be recognised by DSA on the basis of vessel displacement. These lesions are not a primary indication for examination by digital angiography.

Adult↗

Hair-follicle nevus.

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Diagnosis, Differential↗

CT of adenomas of the middle ear and mastoid cavity.

A case of mixed type adenoma of the middle ear and mastoid is presented in which CT showed complete opacification of the middle ear and mastoid air cells with bulging of the tympanic membrane but without ossicular or bony destruction.

Adenoma↗

Regional spread of auricular and periauricular cutaneous malignancies.

Over 90% of all cutaneous malignancies occur in the head and neck. Malignancies involving the external auditory meatus, auricle, and periauricular region are notoriously difficult to control. The morbidity and mortality associated with extension of these malignancies underscore the importance of complete initial removal. We present 14 patients who underwent excision of periauricular lesions. All lesions were less than 2 cm in diameter and previously excised with negative margins. These patients were subsequently referred for regional disease. Twenty-nine percent of the patients failed definitive surgical therapy. We examine the indications for regional lymphadenectomy in the treatment of auricular and periauricular cutaneous malignancies.

Aged↗

Darier's disease associated with basal cell carcinomas.

BACKGROUND: Only three patients have been reported with basal cell carcinomas in skin involved with Darier's disease. OBJECTIVE: We report the fourth case and discuss the possible pathogenetic relationship between both diseases. RESULTS: In our case, oral retinoids made evident other basal cell carcinomas hidden in keratotic papules of the Darier's disease. CONCLUSION: Early excision of the tumor could be obtained.

Administration, Oral↗

Pilomatrixoma of the earlobe.

BACKGROUND: Pilomatrixoma most commonly occurs in the head and neck region, appearing primarily in the first two decades of life. The lesion is described as a tumor with differentiation toward hair cells and surgical excision is the treatment of choice. OBJECTIVE: We report an uncommon localization of a perforating type pilomatrixoma of 5 x 4 x 4 cm in size that developed from the earlobe. METHODS: Histopathological examination revealed pilomatrixoma. Total resection of the tumor was performed. The earlobe was reconstructed by forming a posterior-superior pedicled skin flap. RESULTS: No recurrence was observed and a good cosmetic result was obtained. CONCLUSION: Local recurrence does not generally occur if the tumor is completely removed. The case we present is of interest in having a history of trauma to the region and a relatively rapid growth with perforation of the overlying skin.

Child↗

Paragangliomas of the temporal bone: high-resolution CT studies.

Seventeen patients with 15 surgically proved paragangliomas involving the temporal bone and parapharyngeal spaces were examined with high-resolution computed tomography (CT). Scans were obtained in multiple axial (0 degree, 30 degrees) and coronal (70 degrees, 105 degrees) section planes using 1.5-mm collimation and table incrementation. The purpose of this study was to demonstrate the utility of HRCT in assessing tumor extent and size, with particular emphasis on intrinsic temporal bone invasion. The most characteristic HRCT signs of paraganglioma include: jugular fossa expansion, soft-tissue mass in the hypotympanum and sinus tympani, permeation of the infracochlear surface, dural ballooning adjacent to the jugular fossa (indicative of epidural tumor), anterior displacement of parapharyngeal fat planes, and extension into the proximal aspect of the eustachian canal. It is concluded that HRCT is the single most efficacious examination to determine tumor extent, especially when intratemporal invasion has occurred, and to define other additional clinically unsuspected lesions.

Diagnosis, Differential↗

Bilateral middle ear carcinomas associated with Waldenström's macroglobulinemia.

A case of bilateral middle ear squamous cell carcinomas with concurrent Waldenström's macroglobulinemia is described. An increased incidence of malignant tumors occurring in patients with this potentially fatal, chronic lymphoproliferative disorder is well recognized, but the association with an otological tumor has not previously been reported. The relationship between the two conditions is discussed.

Carcinoma, Squamous Cell↗

Primary squamous cell carcinoma of the middle ear invading the cochlea. A histopathological case report.

This report describes the histopathological changes in the temporal bone of a 71-year-old man who died of meningitis and epidural abscess complicated by primary squamous cell carcinoma of the middle ear. The present case is unusual and differs somewhat from previously reported cases of the primary squamous cell carcinoma of the middle ear in three respects: 1) an extensive invasion of the cancer into the membranous labyrinth, 2) cholesterol deposits in the cochlear spiral canal, and 3) presence of ossifying labyrinthitis. Among these findings, extensive involvement of the inner ear by cancer destroying the lower part of the otic capsule is particularly unusual. It is assumed that squamous cell carcinoma overcame the biological resistance to neoplastic infiltration which probably exists in the otic capsule and the membranous labyrinth.

Aged↗

Malignant melanoma with liver and spleen metastases: case report.

CONTEXT: The diagnosis of primary melanoma is easily confirmed after histological analysis of the lesion, whereas it is rarely diagnosed when the patient even has distant metastases. DESIGN: Case report CASE REPORT: Malignant melanoma is responsible for about 1% of all deaths caused by cancer in the USA and only 3% of all malignant skin diseases. Malignant melanoma is a rare disease, although it corresponds to 65% of all deaths caused by skin cancer. The liver and spleen are rarely the first sites of melanoma metastases. This paper reports on the clinical picture of a patient with fatal malignant melanoma and hepatic and spleen metastases. As this was an un-usual presentation, the melanoma diagnosis could only be made after pathological analysis of the skin and hepatic lesions.

Ear Neoplasms↗

Recurrent glomus tumor of the pinna: report of a case.

We describe a rare case of a glomus tumor of the pinna. The lesion produced a brief but sharp pain that occurred spontaneously, intermittently, and upon tactile stimulation. Surgical excision with wide margins was successful. We believe this to be only the third case of a glomus tumor of the auricle that has been reported in the literature.

Adult↗

[Hidradenoma of external ear].

The authors present a rare case of hidradenoma of the external ear and discussed the clinical picture, as well as diagnostic and therapeutic procedures.

Adenoma, Sweat Gland↗

[Cutaneous angiomyolipoma: a case report and literature review].

Angiomyolipoma is a lesion usually observed in the kidney of patients with tuberous sclerosis. Extrarenal sites are very unusual with sporadic cases in internal organ, soft tissue and skin (fifteen cases have been described in this site). Herein we describe an adding case located on the ear in 58-year-old man reviewing the pertinent literature. The main diagnostic differential criteria are also discussed.

Actins↗