Squamomelanocytic Tumor of the Nail Unit Metastasizing to a Sentinel Lymph Node: A Dermoscopic and Histologic Investigation

Haenssle, Holger A.; Buhl, Timo; Holzkamp, Ricarda; Schön, Michael P.; Kretschmer, Lutz; Bertsch, Hans Peter

doi:10.1159/000342181

Cited by 13 publications

(5 citation statements)

References 30 publications

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“…Collision tumors are defined as two neoplasms composed of different cell origins that present in close proximity but maintain a well‐defined boundary . Combined tumors are defined as neoplasms composed of two phenotypically distinct yet intermingled cell populations, for which the use of immunohistochemical studies is usually required to highlight the two distinct cell populations . Overlap between these tumors may occur in which tumors show a mixed pattern that can fall into both collision and combined categories .…”

Section: Discussionmentioning

confidence: 99%

Cutaneous neoplasms composed of melanoma and carcinoma: A rare but important diagnostic pitfall and review of the literature

et al. 2019

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We report two cases of combined cutaneous tumors composed of melanoma and carcinoma. The first tumor presented as a 5-mm pink-blue macule over the right zygomatic arch in an 85-year-old man. Shave biopsy and immunohistochemical studies revealed that the tumor was composed of melanoma (highlighted by SOX10 and MART-1, with high Ki-67 proliferative index) intermixed with nodular basal cell carcinoma (highlighted by pan-cytokeratin and Ber-EP4). The neoplastic melanocytes were confined to the basal cell carcinoma nodules, and a diagnosis of combined melanoma in situ and basal cell carcinoma was rendered. After therapeutic excision, the patient was disease-free at 9 months after the initial diagnosis. The second tumor presented as a 6-mm pink-brown crusted papule on the right forehead in an 89-yearold man. Shave biopsy and immunohistochemical studies revealed that the tumor was composed of malignant melanoma (MM) (highlighted by S100 and MART-1) intermixed with squamous cell carcinoma (SCC) (highlighted by cytokeratin and p63), and a diagnosis of combined MM-SCC was rendered. These two cases highlight the importance of recognizing these rare types of melanocytic-epithelial cutaneous neoplasms to arrive at an accurate diagnosis that may inform appropriate disease stage and therapy. K E Y W O R D Sbasal cell carcinoma, combined tumors, melanoma, squamous cell carcinoma

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Section: Discussionmentioning

confidence: 99%

Cutaneous neoplasms composed of melanoma and carcinoma: A rare but important diagnostic pitfall and review of the literature

et al. 2019

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“…11 Five cases with a median Breslow depth of 4.2 mm (range, 1.4-6 mm) have had local tumor recurrence and/or regional metastases. 11,21,[28][29][30] Two were BMTs, 1 with a Breslow depth of 1.4 mm and metastases to the cervical lymph nodes and the liver, and another with a Breslow depth of 1.6 mm and multiple cutaneous metastases. 11,31 The third patient had a SMT with a Breslow depth of 6 mm that recurred locally.…”

Section: Discussionmentioning

confidence: 99%

Combined cutaneous tumors with a melanoma component: A clinical, histologic, and molecular study

Amin¹,

Cooper²,

Yélamos³

et al. 2015

Journal of the American Academy of Dermatology

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“…A squamomelanocytic tumor is such a collision tumor that mostly occurs in sun-exposed skin of the face and neck area of older patients [19,20]. Recently, a first squamomelanocytic tumor of the nail unit has been reported [21]. The clinical and dermatoscopic examination revealed an advanced dystrophy of the nail plate with brown to slate-gray periungual pigmentation (corresponding to invasive melanocytes of the melanoma) and several keratin cysts of the adjacent skin (corresponding to areas of keratinization of the squamous cell carcinoma) (Figure 14 A, B).…”

Section: Other Neoplasms Of the Nail Unitmentioning

confidence: 99%

When all you have is a dermatoscope—start looking at the nails

Haenssle

Blum

Hofmann‐Wellenhof

et al. 2014

Dermatol Pract Concept

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Pigmented and non-pigmented nail alterations are a frequent challenge for dermatologists. A profound knowledge of clinical and dermatoscopic features of nail disorders is crucial because a range of differential diagnoses and even potentially life-threatening diseases are possible underlying causes. Nail matrix melanocytes of unaffected individuals are in a dormant state, and, therefore, fingernails and toenails physiologically are non-pigmented. The formation of continuous, longitudinal pigmented streaks (longitudinal melanonychia) may either be caused by a benign activation of matrix melanocytes (e.g., as a result of trauma, inflammation, or adverse drug reactions) or by a true melanocytic proliferation (e.g., in a nevus or melanoma). In general, non-continuous nail alterations, affecting only limited parts of the nail apparatus, are most frequently of non-melanocytic origin. Important and common differential diagnoses in these cases are subungual hemorrhage or onychomycosis. In addition, foreign bodies, bacterial infections, traumatic injuries, or artificial discolorations of the nail unit may less frequently cause non-continuous nail alterations. Many systemic diseases that may also show involvement of the nails (e.g., psoriasis, atopic dermatitis, lichen planus, alopecia areata) tend to induce alterations in numerous if not all nails of the hands and feet. A similar extensive and generalized alteration of nails has been reported after treatment with a number of systemic drugs, especially antibiotics and cytostatics. Benign or malignant neoplasms that may also affect the nail unit include glomus tumor, Bowen’s disease, squamous cell carcinoma, and rare collision tumors. This review aims to assist clinicians in correctly evaluating and diagnosing nail disorders with the help of dermatoscopy.

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Squamomelanocytic Tumor of the Nail Unit Metastasizing to a Sentinel Lymph Node: A Dermoscopic and Histologic Investigation

Cited by 13 publications

References 30 publications

Cutaneous neoplasms composed of melanoma and carcinoma: A rare but important diagnostic pitfall and review of the literature

Cutaneous neoplasms composed of melanoma and carcinoma: A rare but important diagnostic pitfall and review of the literature

Combined cutaneous tumors with a melanoma component: A clinical, histologic, and molecular study

When all you have is a dermatoscope—start looking at the nails

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