• Archives of Plastic Surgery
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• 제33권4호
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• pp.506-509
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• 2006

Purpose: The cutaneous squamous cell carcinoma is the second most common skin malignancy. It is noted that keratoacanthoma is difficult to differentiate from squamous cell carcinoma, clinically or historically. It is still a hypothetical question whether keratoacanthoma is a pseudomalignancy or a form of squamous cell carcinoma. Methods: We report the case of squamous cell carcinoma around left ala of nose in a 64-year-old female patient. Through an incisional biopsy, the mass was found to be keratoacanthoma in the pathologic report. An excisional biopsy was performed. Results: Pathologic report notified that it was found well-differentiated squamous cell carcinoma arising in keratoacanthoma with focal involvement of deep resection margin. Wide excision was made with 0.5-1.5 cm margin and immediate reconstruction was performed. Conclusion: The relationship between keratoacanthoma and squamous cell carcinoma has been debated in the treatment. It is still controversial whether to excise it or not. We concluded that kerathoacanthoma must be removed completely.

• 대한두개안면성형외과학회지
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• 제16권2호
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• pp.92-95
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• 2015

A keratoacanthoma is a rapidly growing cutaneous tumor that spontaneously involutes in most instances. A giant keratoacanthoma is a rare variant and are characterized by lesions larger than 20 mm in diameter. We report a 56-year-old man with a rapidly growing tumor of the right cheek, which was diagnosed as keratoacanthoma. The mass was excised completely under general anesthesia, followed by Limberg flap for reconstruction. Intraoperative frozen section histology suggested the lesion to be a well-differentiated squamous cell carcinoma, whereas final histopathology was consistent with keratoacanthoma. We herein report the first case of a giant keratoacanthoma treated with surgical excision in Korea and discuss the clinical and histopathological features of keratoacanthoma, with a review of the literature.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권6호
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• pp.570-574
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• 2005

Keratoacanthoma is a benign, self-limited epithelial lesion that closely resembles Squamous cell carcinoma(SCC). Keratoacanthoma occur primarily exposed skin in male patients over 45 years of ages. although etiology is unknown, sunlight, genetic, and human papillomavirus factor have been considered. in clinical feature, rapid enlargement occurs over 4$\sim$8 weeks, resulting ultimately in a hemispheric, firm, elevated, asymptomatic nodule that contains a central plug of keratin. When fully developed, the keratoacanthoma contains a core of keratin surrounded by a concentric collar of raised skin. Over the next 4$\sim$8 weeks, static lesion persists. Then undergoes spontaneous regression over the next 6$\sim$8weeks period by expulsion of the keratin core with resorption of the mass. In histologic feature, Keratoacanthoma consists of hyperplastic squamous epithelium growing into the underlying connective tissue. The surface is covered by a thickened layer of parakeratin with central plugging. Epithelium cell shows dysplastic features and the margins the normal adjacent epithelium is elevated. The differential diagnosis includes SCC. Keratoacanthoma present as a exophytic lesion with horny keratin occupying a depression on the top of the lesion, persists static period and undergoes rapid growth compared with SCC. Keratoacanthoma is usually treated by surgical excision or curettage of the base, spontaneous regression does not occur in every case. A 60 years old male who present facial lesion visit our hospital and surgical excision was done. Biopsy result was keratoacanthoma. We report case with review of literatures.

• 한국임상수의학회지
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• 제26권6호
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• pp.616-618
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• 2009

5세령의 페키니즈 견이 발생된 지 1년 된 등쪽 종괴의 평가를 위해 내원하였다. 종괴의 세침흡인 도말 표본의 세포학 검사에서 많은 수의 각화 상피세포와 거대 다핵 세포, 소수의 방추 세포가 관찰되었다. 세포학 검사결과 육아종성 표피낭 또는 모낭 종양이 의심되었고, 결절은 외과적으로 절제한 후 병리조직학적 검사를 실시하였다. 피하의 결절은 부분적으로 결합조직에 둘러싸여 있었으며, 주변조직과 경계가 명확하였다. 그 결절은 중심의 큰 낭과 주변의 작은 낭으로 이루어져 있었으며, 그 낭은 중심부에 층판상의 케라틴이 존재하였고 단층 또는 중층의 기저세포와 편평 상피세포로 둘러싸여 있었다. 다소성으로 다수의 대식구와 소수의 다핵거대세포가 관찰되었다. 이에 기초하여 육아종성 염증이 동반된 keratoacanthoma로 진단하였다. 종괴는 수술 제거 후 재발되지 않고 있다.

• Archives of Plastic Surgery
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• 제50권1호
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• pp.59-62
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• 2023

A 57-year-old man presented with a pigmented papule, 0.4 cm in diameter, on the left lower eyelid. Skin biopsy revealed a basal cell carcinoma, which was excised through a wide excision followed by a full-thickness skin graft (FTSG). Two weeks after the surgery, an erythematous nodule developed in the lower margin of the graft recipient site. The nodule size increased rapidly over 2 weeks, becoming dome-shaped with a central hyperkeratotic plug. A diagnosis of keratoacanthoma (KA) was made, and surgical excision was performed. Histological findings revealed a large, well-differentiated squamous tumor with a central keratin-filled crater and buttress. The human papilloma virus (HPV) genotyping results were negative. Risk factors for KA include trauma, old age, exposure to ultraviolet (UV) radiation, immunosuppression, and HPV infection. KA has most often been reported to develop at the donor site. Although the pathogenesis of KA is unclear, trauma is believed to act as a second insult to a preceding oncogenic insult, such as exposure to UV radiation, resulting in a koebnerization. Herein, we report a case of solitary KA at a FTSG recipient site. This report presents information that may provide guidance during dermatologic surgeries.

• 대한피부과학회지
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• 제56권10호
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• pp.628-630
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• 2018

Disseminated superficial actinic porokeratosis (DSAP) is a rare keratinization disorder. It is histopathologically characterized by the presence of coronoid lamellae and clinically by lesions showing central atrophy with elevated borders. Squamous cell carcinoma originating in the classical Mibelli subtype of porokeratosis is well-documented; however, few reports have described squamous cell carcinoma in DSAP lesions. We report the case of a 76-year-old woman with DSAP who developed Bowen's disease, actinic keratosis, and keratoacanthoma on her face.

• 대한두개안면성형외과학회지
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• 제23권2호
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• pp.77-82
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• 2022

Sarcomatoid squamous cell carcinoma (SSCC), a biphasic malignant tumor consisting of atypical squamous epithelial and mesenchymal elements mixed with epithelioid and spindle cells, is a variant of squamous cell carcinoma. Cutaneous SSCC is very rare and aggressive and has a poor prognosis. Here, we report a case of cutaneous SSCC with satellites and in-transit metastases. A 79-year-old woman presented with a protruding mass on the left temporal area sized 1.2×1.0 cm. The punch biopsy report indicated keratoacanthoma or well-differentiated squamous cell carcinoma. The size of the tumor increased to 2.7×2.0 cm after 8 days. An excisional biopsy was performed with a 2 mm safety margin. The tumor was identified as SSCC with a clear resection margin. Reoperation was performed thrice with an increased safety margin of 10 mm; however, the cancer recurred along with satellites and in-transit metastases. Chemoradiotherapy was administered; however, the size of the tumor increased along with satellites and in-transit metastases. The patient expired 162 days after the initial excision. Complete excision and immediate multidisciplinary approach should be combined during the early stages due to the aggressiveness and poor prognosis of cutaneous SSCC with satellites and in-transit metastasis.