Terada Tadashi, Kamo Mariko, Baba Yuko, Sugiura Makoto
Department of Pathology, Shizuoka City Shimizu Hospital, Shizuoka, Japan.
Cutis. 2012 Oct;90(4):176-8.
Squamous cell carcinoma (SCC) arising within seborrheic keratosis (SK) is rare. We report an 84-year-old woman who presented with a rapidly growing black tumor on her left palpebral eyelid of several years' duration. Clinical examination revealed an elevated hemorrhagic black tumor that measured 0.9 x 0.9 x 0.6 cm. A clinical diagnosis of SK was made, but basal cell carcinoma could not be ruled out; therefore, excision with wide margins was performed. Histologically, the tumor was symmetrical and composed of benign basaloid cells with pseudohorn cysts in a reticulated pattern. The tumor showed heavy melanin deposition. The features were indicative of SK. An atypical cell cluster was seen in the central low area. These cells showed keratin pearls, individual keratinization, mitotic and apoptotic figures, nuclear atypia, and microinvasion, indicating microinvasive SCC. Immunohistochemistry revealed the microinvasive SCC area was true SCC. This case suggests that microinvasive SCC can arise within pigmented reticulated SK.
脂溢性角化病（SK）内发生的鳞状细胞癌（SCC）较为罕见。我们报告了一名84岁女性，其左侧睑裂部眼睑出现一个持续数年且迅速生长的黑色肿物。临床检查发现一个隆起的出血性黑色肿物，大小为0.9×0.9×0.6 cm。临床诊断为SK，但不能排除基底细胞癌；因此，进行了广泛切缘切除。组织学上，肿瘤呈对称性，由良性基底样细胞组成，呈网状排列并有假角囊肿。肿瘤显示有大量黑色素沉积。这些特征提示为SK。在中央低区可见一个非典型细胞簇。这些细胞显示有角化珠、个别角化、有丝分裂和凋亡图像、核异型性及微浸润，提示为微浸润性SCC。免疫组化显示微浸润性SCC区域为真性SCC。该病例提示微浸润性SCC可发生于色素性网状SK内。
