No abstract available.
Muir-Torre Syndrome*

PURPOSE: To present a rare case of Muir-Torre syndrome characterized by the association of sebaceous skin tumors and systemic malignancies. CASE SUMMARY: A 65-year-old female visited our clinic with an irregular nodular mass of the right lower eyelid, which developed 1 year earlier. An excisional biopsy and lower lid reconstruction with Tenzel's semicircular rotational flap was performed under local anesthesia. Histopathologic examination showed well-differentiated sebaceous cells, consistent with sebaceous adenoma. The patient had undergone total abdominal hysterectomy and lower anterior resection due to endometrial cancer and sigmoid colon cancer 5 years before, and nephroureterectomy due to papillary urothelial carcinoma 3 years before. Based on the history of systemic malignancy and sebaceous skin cancer, a diagnosis of Muir-Torre syndrome was made. CONCLUSIONS: When a sebaceous gland tumor of the eyelids is detected, Muir-Torre syndrome should be included in the differential diagnosis, and systemic work-up for the internal malignancy must be performed.
Adenoma ; Aged ; Anesthesia, Local ; Biopsy ; Diagnosis, Differential ; Endometrial Neoplasms ; Eyelids ; Female ; Humans ; Hysterectomy ; Muir-Torre Syndrome ; Sebaceous Glands ; Sigmoid Neoplasms ; Skin ; Skin Neoplasms

Muir-Torre syndrome is defined by concurrent or sequential development of internal malignancy and sebaceous neoplasm or multiple keratoacanthomas. Muir-Torre syndrome is very rare, with only 205 cases reported in the literature. We reported a patient with Muir-Torre syndrome with three internal malignancies. A 64-year-old patient with a history of breast cancer, stomach cancer and colon cancer visited our department for treatment of the skin lesion that occurred five years before on the left cheek. The lesion was excised completely with a resection margin of 1 cm, followed by full-thickness skin graft from left postauricular area for reconstruction. Histopathology revealed a 0.2 x 0.2 x 0.1 cm sized sebaceous carcinoma with 4 mm safety margin. The skin graft was well taken within 7 days after surgery and the patient was discharged to outpatient follow-up. There was no complication related with surgery. Muir-Torre syndrome is very rare, as are sebaceous gland tumors. So if a cancer of the sebaceous gland is diagnosed, screening workup for internal malignancy is recommended. Because of its good prognosis, surgical removal of primary or metastatic cancers may be curative and should be attempted where possible.
Breast ; Breast Neoplasms ; Cheek ; Colon ; Colonic Neoplasms ; Follow-Up Studies ; Humans ; Keratoacanthoma ; Mass Screening ; Muir-Torre Syndrome ; Outpatients ; Prognosis ; Sebaceous Glands ; Skin ; Stomach ; Stomach Neoplasms ; Transplants

Sebaceous carcinoma is a very rare and potentially aggressive carcinoma originating from the epithelial lining of the sebaceous gland. More than 70% of all cases are in the head and neck region, especially the periorbita; therefore, they are classified into ocular and extraocular sebaceous carcinoma. The reported risk factors are advanced age, male sex, previous irradiation, and genetic predisposition for Muir-Torre syndrome. The current case is of sebaceous carcinoma found in the suprapubic area of a 67-year-old male patient who had received liver transplantation 6 years before, and had been receiving oral tacrolimus. Examination of the gastrointestinal system did not reveal any other malignancies. Although nonmelanoma skin cancers may occur as a complication after liver transplantation, there have been no previous reports of sebaceous carcinoma after liver transplantation. Furthermore, the sebaceous carcinoma in this case occurred in an uncommon location. We report this case along with a review of the literature.
Aged ; Genetic Predisposition to Disease ; Head ; Humans ; Liver Transplantation ; Liver* ; Male ; Muir-Torre Syndrome ; Neck ; Risk Factors ; Sebaceous Glands ; Skin Neoplasms ; Tacrolimus ; Transplantation*

In recent years, there has been a significant global increase in skin cancer incidence, which continues to pose a significant challenge to public health. This retrospective study aimed to comprehensively characterize the epidemiology of histopathologically diagnosed skin cancers at the Department of Dermatology, Jose R. Reyes Memorial Medical Center from January 2013 to December 2022. The research encompassed an analysis of demographic and clinical profiles in 352 cases. The cases consisted of basal cell carcinoma (BCC) (161, 46%), squamous cell carcinoma (SCC) (62, 18%), melanoma (21, 6%), mycosis fungoides (MF) (37, 11%), other cutaneous T-Cell lymphomas (11, 3%), mammary Paget’s disease (7, 2%), extramammary Paget’s disease (6, 1.7%), Langerhans cell histiocytosis (LCH) (8, 2%), sebaceous carcinoma (3, 1%), Merkel cell carcinoma (MCC) (1, 0.3%), dermatofibrosarcoma protuberans (1, 0.3%), angiosarcoma (2, 0.6%), Kaposi sarcoma (3, 0.9%), and cutaneous metastasis (29, 8%). Among the primary cutaneous malignancies, BCC, SCC, MF, and melanoma were the most frequently encountered types. The findings reveal a notable upward trend in all skin cancer incidence, and projections suggest a continued increase in the next five years. BCC and SCC were more common in males and affected predominantly sun-exposed areas, while melanoma exhibited a slight female preponderance and primarily affected the lower extremities (acral melanoma). These skin cancers were more common among elderly individuals. The study highlights the need for standardized documentation to improve data quality on epidemiology. This, in turn, can lead to improved early detection, prevention, and better management of this escalating global public health issue.

Adenoma, Sweat Gland ; metabolism ; Diagnosis, Differential ; Humans ; Keratin-14 ; metabolism ; Keratin-17 ; metabolism ; Keratin-18 ; metabolism ; Keratin-7 ; metabolism ; Keratins ; metabolism ; Papilloma ; metabolism ; Sebaceous Gland Neoplasms ; metabolism ; Skin Neoplasms ; metabolism ; Sweat Gland Neoplasms ; metabolism

BACKGROUND

Mohs micrographic surgery (MMS) is the preferred surgical procedure for non melanoma skin cancers (NMSCs), especially in areas where function and cosmesis are critical. It allows precise removal of the tumor while preserving normal skin tissue.

This study aimed to describe the clinicohistopathologic profile of patients who underwent MMS at the Dermatology Center of the St. Luke’s Medical Center, Quezon City, Philippines (SLMC-QC) from March 2003 to March 2023.

This was a descriptive cross-sectional study utilizing a 20-year chart review on all patients who underwent MMS at SLMC-QC from March 2003 to March 2023. Data collected were the following: age, sex, race, clinicopathologic diagnosis, tumor site, pre-operative and post-operative area size, number of MMS stages, type of repair performed, and recurrence, if any.

In 20 years, there were a total of 684 cases done in the Dermatology Center SLMC-QC, and 573 cases with complete data were included. Eighty six percent of patients were over 50 years old. There was a slight male predominance, and most patients were Asians, followed by Caucasians. Basal cell carcinoma was the most common diagnosis followed by squamous cell carcinoma and Bowen’s disease. Majority of the tumors were located on the head and neck. The postoperative defect increased by 2-to-3-fold from the preoperative tumor size in most cases. Most tumors were cleared in 2 stages. The most common type of repair done was flaps, followed by full-thickness skin grafts and primary closures. All primary tumors treated in the center have not recurred within 5 years, bringing the cure rate to 100%.

The clinicohistopathologic profiles of patients in this study are similar to those reported in the literature. No recurrence has been reported in the center and this reflects the effectivity of MMS.

A 42-year-old woman was treated with total abdominal hysterectomy and bilateral salpingo- oophorectomy due to endometrial carcinoma 3 years ago, and has taken regular check-ups ever since. A 1.0cm-sized, yellow-orange colored, pedunculated mass had ben developed on her scalp about 1 year before. Excision showed an exophytic pedunculated, well-circumscribed nodule composed of predominant undifferentiated basaloid cells, some vacuolated sebocytes and numerous sebaceous duct like structures. There was no relapse during the follow-up of about 6 months. The development of sebaceous epithelioma in this case would be associated with Muir-Torre syndrome.
Adult ; Carcinoma* ; Endometrial Neoplasms ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Muir-Torre Syndrome ; Ovariectomy ; Recurrence ; Scalp

PURPOSE: To report a rare case of sebaceoma misdiagnosed as chalazion. CASE SUMMARY: A 42-year-old female presented with a visible mass in her right lower eyelid. An elevated, hard mass was located at the margin of the right lower eyelid, and she had a history of incision and curettage under the clinical impression of chalazion. On eversion of the lower eyelid, the tarsal portion of the mass was visible as a white-yellowish lesion. The mass was excised under local anesthesia. A sebaceoma was diagnosed based on histopathological examinations. Immunohistochemical studies showed positive staining results for mutator L homologue 1 (MLH1), mutator S homologue 2 (MSH2), and mutator S homologue 6 (MSH6), and she had no past medical history or family history of internal malignancy, suggesting a low possibility of Muir-Torre syndrome. CONCLUSIONS: Eyelid sebaceoma should be considered as a differential diagnosis for refractory chalazion.
Adult ; Anesthesia, Local ; Chalazion* ; Curettage ; Diagnosis, Differential ; Eyelids* ; Female ; Humans ; Muir-Torre Syndrome

Muir-Torre syndrome is defined by concurrent or sequential development of internal malignancy - most commonly colorectal cancer - and sebaceous neoplasm or multiple keratoacanthomas. Recent studies revealed it was caused by mutations in DNA mismatch repair genes, and suggested screening for mismatch repair gene defects may be of value for patients with Muir-Torre syndrome. We, herein, report a patient with Muir-Torre syndrome, who developed breast cancer and extra-ocular sebaceous carcinoma. In addition, we discussed our experience of immunohistochemical staining for mismatch repair protein with a review of the literature.
Breast ; Breast Neoplasms ; Colorectal Neoplasms ; DNA Mismatch Repair ; Humans ; Keratoacanthoma ; Mass Screening ; Muir-Torre Syndrome