Yumeen Sara, Gowda Asha, Hsu Mei-Yu, Kroumpouzos George
Dermatology, Warren Alpert Medical School at Brown University, Providence, USA.
Dermatopathology, StrataDx, Lexington, USA.
Cureus. 2023 Mar 9;15(3):e35934. doi: 10.7759/cureus.35934. eCollection 2023 Mar.
A case of annular basal cell carcinoma (BCC) with central atrophic scarring that developed secondary to spontaneous regression has been reported. We present a novel case of a large, expanding nodular and micronodular BCC with annular morphology with central hypertrophic scarring. A 61-year-old woman presented with a two-year history of a mildly itchy lesion on the right breast. Previously diagnosed as an infection, the lesion persisted after treatment with topical antifungal agents and oral antibiotics. Physical examination revealed a 5x6 cm plaque consisting of a pink-red arciform/annular edge with an overlying scale crust and a large, centrally positioned, firm, alabaster-colored portion. A punch biopsy of the pink-red rim revealed nodular and micronodular BCC features. A deep shave biopsy of the central bound-down plaque showed histopathology of scarring fibrosis with no findings of BCC regression. The malignancy was treated with two sessions of radiofrequency destruction, which led to the resolution of the tumor with no recurrence to date. Contrary to the previously reported case, BCC in our case was expanding, associated with hypertrophic scarring, and showed no signs of regression. We discuss several possible etiologies of the scarring centrally. With further awareness of this presentation, more such tumors can be detected at early stages to facilitate prompt treatment and prevent local morbidity.
已报告一例环状基底细胞癌（BCC），其中心萎缩性瘢痕继发于自发消退。我们报告一例新的大型、扩展性结节状和微结节状环状形态的BCC病例，伴有中心肥厚性瘢痕。一名61岁女性，右乳出现轻度瘙痒性皮损两年。该皮损先前诊断为感染，经外用抗真菌药和口服抗生素治疗后仍持续存在。体格检查发现一个5×6 cm的斑块，由粉红色弧形/环状边缘、上覆鳞屑痂皮以及一个大的、位于中央的、坚实的、象牙白色部分组成。对粉红色边缘进行打孔活检显示为结节状和微结节状BCC特征。对中央固定的斑块进行深部削除活检，显示为瘢痕性纤维化的组织病理学表现，未发现BCC消退迹象。该恶性肿瘤接受了两次射频消融治疗，肿瘤消退，至今未复发。与先前报道的病例不同，我们病例中的BCC在扩展，伴有肥厚性瘢痕，且无消退迹象。我们讨论了中央瘢痕形成的几种可能病因。随着对这种表现的进一步认识，更多此类肿瘤可在早期被检测到，以便及时治疗并预防局部并发症。
