The reflectance confocal microscopy features of sebaceous adenoma in a case of Muir Torre syndrome

Abstract

Muir-Torre syndrome (MTS) is a rare genodermatosis characterized by the occurrence of sebaceous gland neoplasms and/or keratoacanthomas associated with visceral malignancies. It is autosomal dominantly inherited and considered as a subtype of Lynch 2 syndrome, which is a hereditary nonpolyposis colorectal cancer syndrome. Sebaceous adenoma, sebaceoma, sebaceous carcinoma and keratoacanthoma are the most frequent associated cutaneous neoplasms. The most common visceral malignancies are colorectal and genitourinary tumors. A 47-yearold male patient was admitted to our clinic with the complaint of two lesions on the nose. Dermatological examination revealed a plaque 1 cm in diameter consisting of bright yellowish-white colored papules with slightly umbilicated appearance, and telangiectasias on the left side of the nose and a dome-shaped papule 3 mm in diameter with hyperkeratotic plug on the tip of the nose. He had a history of partial colon resection due to colon cancer and familial Lynch II syndrome. On dermoscopic examination of sebaceous adenoma, a few yellow comedo-like globules and branching arborizing vessels were detected. Reflectance confocal microscopy (RCM) revealed a good histopathologic correlation. Sebaceous lobules were composed by clusters of ovoid cells with hyporefractile dark nuclei and bright, hyperrefractile glistening cytoplasm. Numerous round to oval-shaped dark spaces corresponding to sebaceous ducts were detected. The diagnosis of MTS was established based on the personal and family history, dermoscopic, RCM and histopathologic findings. MTS evaluation is required in patients with biopsy-proven sebaceous adenoma. Early diagnosis may be lifesaving in patients with MTS. A better characterization of RCM features of sebaceous tumors will allow early diagnosis of the patients with MTS. (Turkderm 2015; 49: 70-4) Key Words: Sebaceous adenomas, Muir Torre syndrome, reflectance confocal microscopy Conflicts of Interest:The authors reported no conflict of interest related to this article.Muir Torre sendromu (MTS) sebase tümörlere ve/veya keratoakantomlara eşlik eden visseral malignitelerle karakterize, nadir görülen bir genodermatozdur. Otozomal dominant olarak kalıtılır ve Herediter nonpolipozis kolorektal kanser sendromu olan Lynch 2 sendromunun bir subtipi olarak kabul edilir. Sıklıkla eşlik eden kutanöz neoplaziler sebase adenom, sebaseoma, sebase karsinom, ve keratoakantomdur. En sık görülen internal maligniteler gastrointestinal sistem tümörleridir. Kırk yedi yaşında erkek hasta burunda iki adet kabarık yara şikayetiyle polikliniğimize başvurdu. Dermatolojik muayenesinde burun sol yanında 1 cm çapında, sarımsı-beyaz renkte parlak papüllerden oluşan, hafif umblike, üzerinde telenjiektazilerin izlendiği plak ve burun ucunda 3 mm çapında, soluk eritemli, ortasında keratotik tıkaç bulunan kubbemsi papül mevcuttu. Daha önce kolon kanseri nedeniyle parsiyel kolon rezeksiyonu yapılmış olan hastada ailesel Lynch 2 sendromu öyküsü mevcuttu. Sebase adenomun dermoskopik incelemesinde az sayıda sarı komed...

In Vivo Reflectance Confocal Microscopy of Adnexal Tumors: Evaluation of Trichoepithelioma, Sebaceoma, and Fibrofolliculoma

“…There is only one study that examined sebaceous tumors by RCM in English 11 and one such report in Turkish. 12 Furthermore, there are an insufficient number of cases of sebaceous neoplasms that have been studied by RCM, forcing their differences to be individualized solely by confocal microscopy.…”