Background: Dermatomyofibroma (DMF) represents a rare and distinct benign cutaneous mesenchymal neoplasm of fibroblastic/myofibroblastic differentiation. Approximately 150 cases of DMF have been documented in the literature. Nevertheless, the occurrence of DMF on the face is exceptionally rare. Clinically, DMF is often misdiagnosed as a scar, keloid or dermatofibrosarcoma protuberans. Thus, histopathological and immunohistochemical analyses are instrumental in establishing a differential diagnosis. We present a rare case of dermatomyofibroma that occurred in the facial region. Case presentation: A 20-year-old female patient presented to Sundara Dermatology Clinic in August 2025, with a lesion that had persisted for two years on her left masseteric region. Previously, she had consulted at the National Dermatology Center, where she was diagnosed with “acne scar” and underwent an intradermal triamcinolone injection once. However, the treatment proved ineffective, and the lesion gradually increased in size. Upon physical examination, a poorly circumscribed, irregularly elevated, firm, brown plaque measuring 2.5 x 2 cm in size was observed on the left upper chin, extending to the preauricular region. Diagnosis: A skin biopsy was performed to establish the diagnosis. Histopathological examination suggested differentiating Dermatomyofibroma from Dermatofibrosarcoma protuberans. Therefore, immunohistochemical analysis utilizing CD34 and SMA markers was conducted. Based on the histological and immunohistochemical findings, the final diagnosis was confirmed as Dermatomyofibroma. Treatment: The standard treatment for DMF is complete surgical excision of the tumor. After providing the patient with an accurate diagnosis and recommending surgical excision, she underwent a surgery and the tumor was completely excised. To date, no instances of recurrence have been noted. Conclusion Dermatomyofibroma is a rare benign cutaneous neoplasm characterized by clinical features that overlap with other dermatological conditions, which increases the risk of misdiagnosis and inappropriate treatment. We emphasize the critical role of skin biopsy and immunohistochemical analysis in cases with similar clinical manifestations, thereby mitigating the risk of further misconduct.

Background: Basal cell carcinoma stands as the most prevalent cutaneous malignancy, originating from the basal cells of the epidermis. Approximately 4 million new cases are diagnosed globally annually. In contrast, schwannoma is a rare benign nerve sheath tumor arising from Schwann cells. The simultaneous occurrence of these two tumors within a single lesion is exceedingly uncommon. We present a rare case of basal cell carcinoma coexisting with cutaneous schwannoma. Case Presentation: A 68-year-old European male patient presented to Sundara Dermatology Clinic in April 2025 with a complaint of a persistent facial lesion that had not healed. The lesion initially manifested in June 2024 as a small, asymptomatic lesion, which the patient disregarded, attributing it to minor trauma during shaving. Recently, the lesion has exhibited an increase in size and occasional bleeding. Upon the physical examination, a round to oval-shaped, elevated papular lesion with central ulceration and crusting was observed on the right nasolabial fold. Diagnosis: A skin biopsy was conducted to ascertain the diagnosis. Histopathological examination indicated the presence of basal cell carcinoma in conjunction with schwannoma or neuroma, necessitating a differential diagnosis. Immunohistochemical analysis employing markers such as S100, BCL2, P63, CD10, and actin was performed. Upon analyzing the histological and immunohistochemical findings, the final diagnosis was confirmed as Basal cell carcinoma coexisting with schwannoma. Treatment: Surgical excision is the standard treatment for both basal cell carcinoma and schwannoma. The patient was advised accordingly and underwent complete surgical removal of the tumor. No recurrence has been observed during postoperative follow-up. Conclusion The coexistence of basal cell carcinoma and cutaneous schwannoma within a single lesion is exceedingly rare. Clinically, basal cell carcinoma frequently mimics other dermatological conditions, necessitating meticulous differentiation. It is imperative to emphasize the paramount importance of skin biopsy and immunohistochemistry in the differential diagnosis and optimal treatment selection.