Melanoma Within the Seborrheic Keratosis

Thomas, Isabelle; Kihiczak, Nadia I.; Rothenberg, Jerry; Ahmed, Shahida; Schwartz, Robert A.

doi:10.1097/00042728-200404000-00023

Cited by 3 publications

(5 citation statements)

References 17 publications

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“…Their mean age was 71 years (standard deviation (SD) 9 years). Further baseline demographics information has been published previously (3). Participants had a mean of seven AKs (SD 10) at baseline.…”

Section: Resultsmentioning

confidence: 99%

“…The development of malignant melanoma contiguous with or adjacent to seborrhoeic kératoses is uncommon but has been documented previously (1)(2)(3)(4)(5).…”

mentioning

confidence: 99%

“…This habit should be abandoned. At the very least, every seborrhoeic keratosis a doctor intends to excise should be subjected to dermoscopic examination in order to avoid missing other colocalized malignant lesions, such as melanomas (1)(2)(3)(4)(5). Actinic kératoses (AKs) are common dysplastic lesions with potential to transform into keratinocyte carcinomas (KC; basal and squamous cell carcinomas) (1), and they present a substantial cost because they are so common (2).…”

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confidence: 99%

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What Can Hide Under ExophytIc Verrucous Appearance?

Giorgi¹,

Grazzini²,

Savarese³

et al. 2011

Acta Derm Venerol

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A 70-year-old Caucasian woman attended our pigmented lesions clinic for routine treatment. On examination, numerous seborrhoeic kératoses were found on her trunk and limbs. She reported that a lesion in the centre of her abdomen had increased in size over the previous year. Clinical examination revealed a symmetric lesion comprising two well distinct areas of pigmentation, one light brown and the other dark brown, and exhibiting a typical exophytic verrucous appearance (Fig. 1). Dermoscopic evaluation of the whole lesion revealed the presence of pseudo-horn cysts, comedo-like openings and fissures. Moreover, a pigmented network, as well as globules and pseudopods, were found in one part of the lesion (Fig. 2).A tentative diagnosis of collision tumour involving a seborrhoeic keratosis and atypical melanocytic lesion was made, and we decided to surgically remove the entire lesion. Histopathological examination of the excised tissue revealed a hyperkeratotic (papillomatous) seborrhoeic keratosis converging with an exophytic, verrucous lesion (displaying melanocytic activity) at the dermoepidermal junction and superficial dermis. The hyperkeratotic seborrhoeic keratosis displayed papillomatosis, acanthosis and the proliferation of basaloid cells with a varying admixture of squamoid cells, keratin-filled invaginations and hom cysts. Similar to conventional seborrhoeic keratosis, there were, at the dermoepidermal junction in the area of skin affected by seborrhoeic keratosis-like changes, nests of atypical melanocytes, some of which formed pagetoid spread in the epidermal fronds. The dermis, meanwhile, contained -20 -15 -10 -5 Fig. 2. Demiuscopic image of the same lesion shown in I ig. 1 JcniDnstrating pseudo-hom cysts, comedo-like openings and fissures. One part of the lesion also displayed a pigmented network, globules and pseudopods.tightly-packed aggregates of small darkly-staining cells resembling naevus cells. These cells displayed hypcrchromatic, angulated nuclei, scant cytoplasm and occasionally prominent nucleoli. The final diagnosis was hyperkeratotic seborrhoeic keratosis in collision with verrucous and keratotic nevoid melanoma (Fig. 3). The melanoma was a Clark level II tumour in the vertical growth phase. It had a Breslow thickness of 0.8 mm.The development of malignant melanoma contiguous with or adjacent to seborrhoeic kératoses is uncommon but has been documented previously (1-5).A retrospective analysis of 618 cases of malignant melanoma (6) identified 10 lesions with marked verrucous and keratotic patterns that were initially clinically diagnosed as benign lesions. Fig. I. Macroscopic image of a malignant melanoma arising from a seborrhoeic keratosis. Acta Derm Venereol 91 Fií^. 3. l!\pcrkcr¿iti>lic schonhocic m COIIISUMI \\ilh novoid melanoma.Melanoma cells are associated with scattered meanophages and signs of fibrosis in the superficial dermis (inset).

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Section: Resultsmentioning

confidence: 99%

“…The development of malignant melanoma contiguous with or adjacent to seborrhoeic kératoses is uncommon but has been documented previously (1)(2)(3)(4)(5).…”

mentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

What Can Hide Under ExophytIc Verrucous Appearance?

Giorgi¹,

Grazzini²,

Savarese³

et al. 2011

Acta Derm Venerol

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“…Thomas et al have reported a case in which clinically suspected seborrheic keratosis was subjected to biopsy and histologically it proved to be malignant melanoma. So biopsy is not only warranted but very much necessary to identify malignant melanoma that can be missed [9] or underdiagnosed. Recent studies have also used dermoscopy as a useful method for differential diagnosis of pigmented skin [3] lesions.…”

Section: Sudden Onset Of Numerous Eruptive Seborrheicmentioning

confidence: 99%

Pigmented Seborrheic Keratosis (Melanoacanthoma) of Nipple A case report with review of literature

Narasimha¹,

ML²,

MN³

et al. 2013

JCBS

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Seborrheic Keratosis is a benign skin lesion which develops from the proliferation of keratinocytes of the epidermis. There are very few case reports of seborrheic keratosis occurring over the nipple and areola. Pigmented seborrheic keratosis can be easily mistaken for malignant melanoma. Its occurrence may be associated with internal malignany (Leser-Trelat sign). We report a case of pigmented seborrheic keratosis of nipple in a 43 year old lady, its associations and differential diagnosis.

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“…[1][2][3][4][5][6][7][8][9] Thus, SK may present a pitfall in melanoma diagnosis with potentially dire consequences for patients.…”

Section: Introductionmentioning

confidence: 99%