Four Different Tumors Arising in a Nevus Sebaceous

Abstract

Nevus sebaceous is known by its association with one or more secondary tumors, but more than three multiple tumors arising from a nevus sebaceous is extremely rare. A 67-year-old female presented with a light brown plaque on the back of her head that contained a dome-shaped black node and an erosive lesion. Histopathological examination showed atypical basaloid cells in the black node. At the periphery of that node, structures resembling follicular germs extruded from interlacing cords in the upper portion and tumor nests with sebocytes were in the lower portion. In the erosive lesion, papillated structures with an apocrine epithelium were observed. In the light brown plaque, enlargement of sebaceous lobules was noted. From those histopathological features, a diagnosis of syringocystadenoma papilliferum, sebaceoma, trichoblastoma and basal cell carcinoma arising from a nevus sebaceous was made. We discuss the rarity of multiple tumors arising from a nevus sebaceous.

<p>Multiple Skin Neoplasms at One Site (MUSK IN A NEST): A Comprehensive Review of Basal Cell Carcinoma and Benign or Malignant “Collision” Tumors at the Same Cutaneous Location</p>

“…Sebaceous hyperplasia 19 Fibrous tumors Dermatofibroma 21,22 Hamartomas Epidermal nevus 23 Nevus sebaceus [4][5][6][7][8][9][10][11] Keratinous tumors…”

“…In addition to the benign apocrine neoplasm, most of these patients MUSK IN A NEST developed in a nevus sebaceus; in addition, many of the individuals had additional neoplasm present. [4][5][6][7][8][9][10][11] One patient, a 65-year-old man with a growing 6 centimeter exophytic mass on his left occipital scalp of 5-years duration, also had a concurrent verrucous carcinoma. 12 BCC has also been associated with benign follicular and sebaceous adnexal tumors.…”

“…85 However, several nevus sebaceous contain not only BCC but also syringocystadenoma papilliferum and/or other tumors. [4][5][6][7][8][9][10][11]…”

“…However, BCC associated with two or more additional skin neoplasms have been observed (Table 4). [4][5][6][7][8][9][10][11][12]24,32,34,43,45,46,[79][80][81]…”

Ultrasound Imaging of Nevus Sebaceous of Jadassohn

“…Clinically, it presents as a yellowish and hairless plaque that, over time, becomes thick and presents mamillonated and verrucous contours 2,5 . In early childhood, this lesion can mimic other dermatologic entities such as aplasia cutis, 6 and in adulthood, NSJ is known by its association with one or more secondary tumors 2,4,5,7–9 . These secondary neoplastic lesions include several benign adnexal tumors and skin cancer, particularly basal cell carcinoma (BCC) 2,5,9 …”