BACKGROUND: Jeju Island is geographically and socioeconomically distinct from the mainland of South Korea. Thus, the presentation and management of non-melanocytic skin cancers (NMSC) of the head and neck may differ from those in other regions of the country. We compared the clinical characteristics and treatment modalities of NMSC on Jeju Island with the findings of similar regional studies. METHODS: Patient data, including age, sex, diagnosis, tumor site, treatment, and recurrence, were obtained from the medical and pathology records of patients diagnosed with NMSC between January 2010 and June 2015. RESULTS: In total, 190 patients (57 men) with a mean age of 75 years (range, 42–97) were assessed. Overall, 203 NMSCs were diagnosed, including 123 basal cell carcinomas and 80 squamous cell carcinomas. The tumor sites included the nose, cheeks, periorbital area, and lips (n=55, 54, 25, and 20, respectively). We identified 92 T1-stage and 60 T2-stage tumors, and 120 cases were treated with wide surgical resection and 17 cases were treated with radiation therapy at the medical center. Of the 120 cases treated surgically, 69 required reconstructive surgery using a local skin flap, 22 required full-thickness skin grafting, and 12 underwent primary closure. Basal and squamous cell carcinomas recurred in 2 and 1 cases, respectively. CONCLUSIONS: Compared to the reports from other regions, the average patient age was 10 years higher, with a marked female preponderance. While the proportion of squamous cell carcinoma was higher than in other regions, the tumor distribution and surgical management profiles were similar.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cheek ; Clinical Study* ; Diagnosis ; Female ; Head* ; Humans ; Korea ; Lip ; Neck* ; Nose ; Pathology ; Recurrence ; Skin Neoplasms* ; Skin Transplantation ; Skin*

A cutaneous sinus tract of odontogenic origin occurs when purulent by-products of dental pulp necrosis spread along the path of least resistance from the root apex to the skin on the face. Patients presenting with this condition usually visit a dermatologist first, as the lesion can mimic various dermatologic pathologies, ranging from an epidermal cyst to basal cell carcinoma. The location of the sinus in the head and neck region should lead the dermatologist to seek a dental origin in order to avoid misdiagnosis. The lesion may persist for long periods before a correct diagnosis is made and the odontogenic source is treated appropriately. Herein, we report a case of a cutaneous sinus tract of odontogenic origin.
Carcinoma, Basal Cell ; Dental Fistula ; Dental Pulp Necrosis ; Diagnosis ; Diagnostic Errors ; Epidermal Cyst ; Head ; Humans ; Neck ; Pathology ; Skin

BACKGROUND: Skin cancer is the most common type of cancer. Of the 4 million skin lesions excised annually worldwide, approximately 2 million are considered cancerous. In this study, we aimed to describe a regional experience with skin cancers treated by a single senior surgeon and to provide a treatment algorithm. METHODS: The medical records of 176 patients with head and neck non-melanocytic skin cancer (NMSC) who were treated by a single surgeon at our institution between January 2010 and May 2016 were retrospectively reviewed, and their data (age, sex, pathological type, tumor location/size, treatment modality) were analyzed. Patients with cutaneous squamous cell carcinoma (cSCC) who were classified as a high-risk group for nodal metastasis underwent sentinel node mapping according to the National Comprehensive Cancer Network guidelines. RESULTS: Among the patients with NMSC who were treated during this period, basal cell carcinoma (BCC; n=102, 57.9%) was the most common pathological type, followed by cSCC (n=66, 37.5%). Most lesions were treated by complete excision, with tumor-free surgical margins determined via frozen section pathology. Thirty-one patients with high-metastasis-risk cSCC underwent sentinel node mapping, and 17 (54.8%) exhibited radiologically positive sentinel nodes. Although these nodes were pathologically negative for metastasis, 2 patients (6.5%) later developed lymph node metastases. CONCLUSION: In our experience, BCC treatment should comprise wide excision with tumor-free surgical margins and proper reconstruction. In contrast, patients with cSCC should undergo lymphoscintigraphy, as nodal metastases are a possibility. Proper diagnosis and treatment could reduce the undesirably high morbidity and mortality rates.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Diagnosis ; Frozen Sections ; Head* ; Humans ; Lymph Nodes ; Lymphoscintigraphy ; Medical Records ; Mortality ; Neck* ; Neoplasm Metastasis ; Pathology ; Retrospective Studies ; Skin Neoplasms* ; Skin*

BACKGROUND: There have been many changes to the social and medical environment in Korea and many studies showed a steady increase of cutaneous tumors. But none of them included a data occurring from head and neck. OBJECTIVE: To investigate the incidence and distribution of the cutaneous tumors of the head and neck. METHODS: A total of 1,415 cases of head and neck cutaneous tumors were obtained from pathology specimen at Department of Dermatology between 2010 and 2014. RESULTS: Among 1,415 cases of head and neck cutaneous tumors, 871 cases (61.5%) were benign tumors, 271 cases (19.2%) were malignant tumors, and 273 cases (19.2%) were premalignant lesions. The most common benign head and neck cutaneous tumors was epidermal cyst with 188 cases (21.6%), followed by 173 cases (19.9%) of seborrheic keratosis, 71 cases (8.2%) of intradermal nevi. Among the 271 cases of malignant head and neck cutaneous tumors, there were 164 cases (60.5%) of basal cell carcinoma, 89 cases (32.8%) of squamous cell carcinoma, 5 cases (1.8%) of malignant melanoma. The predilection sites of malignant head and neck tumors were face (87.5%), ear (4.8%) and neck (4.0%). Of the premalignant lesions, there were 210 cases (76.9%) of actinic keratosis, 36 cases (13.2%) of Bowen's disease and 27 cases (9.9%) of actinic cheilitis. CONCLUSION: In our study, the proportion of malignant tumors and premalignant lesion in head and neck tumors was higher than previous reports. Also, the percentage of woman in malignant tumors and premalignant lesions was higher than man, unlike previous studies. However, these results had limitation associated with retrospective study in a single institution, and further prospective study with multi-center is required for confirmation.
Actins ; Bowen's Disease ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cheilitis ; Clinical Study* ; Dermatology ; Ear ; Epidermal Cyst ; Female ; Head* ; Humans ; Incidence ; Keratosis, Actinic ; Keratosis, Seborrheic ; Korea ; Melanoma ; Neck* ; Nevus, Intradermal ; Pathology ; Prospective Studies ; Retrospective Studies

Patients found two years left of the new biology, surface erosion,exudates long. Postoperative pathology examination: inflammatory fibrous background visible uniform small cells arranged in cords, pseudorosette formation region is considered not except basal cell carcinoma , neuroendodrne carcinoma. Diagnosis of immunohistochemical support of basal cell carcinonma.
Carcinoma, Basal Cell ; diagnosis ; pathology ; Humans ; Immunohistochemistry ; Skin Neoplasms ; diagnosis ; pathology

OBJECTIVE: To analyze the diagnosis, therapy and prognosis of the rare cases of malignant tumors in external auditory canal. METHOD: Eight cases of rare malignant tumors in external auditory canal were collected except squamous cell carcinoma and adenoid cystic carcinoma. The clinical manifestation, staging, surgical method, secondary treatment and prognosis were analysed. RESULT: There were 5 cases of basal cell carcinoma and 2 cases of mucoepidermoid carcinoma and 1 case of myoepithelial carcinoma. Three cases of the 5 basal cell carcinoma in external auditory canal have been misdiagnosed for a long time. After admission, 4 of the 5 basal cell carcinoma were T1 stage and cured only by a complete resection of tumor. One case of T2 stage basal cell carcinoma was found recurrence 2 years later after the first excision of tumor, and was treated with radiotherapy. Tumor was controlled. Two cases of mucoepidermoid carcinoma had been misdiagnosed as a benign tumor and received a resection. One case was found metastasis to the parapharyngeal space and nasopharynx and was treated with concurrent chemotherapy. Tumor was also controlled after 5-years follow-up. Another case was found metastasis to parotid gland and received an expanding tumor resection. No recurrence was detected after a 1-year followed up. One case of T4 stage myoepithelial carcinoma in external auditory canal was a metastasis of parotid and received a partial temporal bone resection. No-recurrence was found 1 year later. CONCLUSION Because the tumors above have a very low incidence in external ear canal and the location of tumors are hidden, they are often misdiagnosed and delayed in treatment. Therefore, otologists should pay more attention to avoid the misdiagnosis. To the treatment, complete surgical resection of early-stage tumor is important and for late-stage tumor, a supplemented by chemoradiotherapy may be needed.
Carcinoma, Adenoid Cystic ; diagnosis ; surgery ; Carcinoma, Basal Cell ; diagnosis ; surgery ; Carcinoma, Squamous Cell ; diagnosis ; surgery ; Ear Canal ; pathology ; Ear Neoplasms ; diagnosis ; surgery ; Humans ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Parotid Gland ; pathology ; Prognosis ; Retrospective Studies ; Temporal Bone ; surgery

We herein present the case of a 55-year-old woman with a previous history of malignancies--uterine adenocarcinoma, basal cell carcinoma (which occurred twice consecutively), recurrent respiratory infections due to common variable immunodeficiency (CVID), and systemic granulomatous disease diagnosed at a later age. The patient suffered from diffuse large B cell lymphoma (DLBCL), which was successfully treated with R-CHOP chemotherapy, and continued with immunoglobulin supplementation. The patient was free of lymphoma and infectious complications for over 20 months despite her persistent immunodeficiency, but eventually developed colorectal adenocarcinoma. To the best of our knowledge, this is the first reported case of CVID associated with multiple solid tumours and DLBCL.
Adenocarcinoma ; etiology ; Carcinoma, Basal Cell ; etiology ; Common Variable Immunodeficiency ; complications ; diagnosis ; therapy ; Fatal Outcome ; Female ; Humans ; Lymphoma, Large B-Cell, Diffuse ; etiology ; Middle Aged ; Neoplasms, Multiple Primary ; etiology ; pathology ; therapy ; Respiratory Tract Infections ; etiology ; Skin Neoplasms ; etiology ; Uterine Neoplasms ; etiology

OBJECTIVETo investigate the histogenesis, clinicopathologic characteristics, pathologic diagnosis, differential diagnosis, treatment and prognosis of basal cell carcinoma of the Prostate (BCCP).

METHODSWe conducted clinicopathologic analysis on the manifestations of 5 cases of BCCP by HE staining and immunohistochemistry and reviewed relevant literature.

RESULTSMicroscopically, the tumor cells were small in volume with ovoid karyomegaly and mitosis, some arranged like a solid nest or with a cribriform appearance. The tumors displayed an invasive growth, with positive expressions of 34betaE12, P63 and Cytokeratin 14, and negative expressions of PSA and P504s. No recurrence and metastasis were found in these patients during over 12 months of follow-up after surgery.

CONCLUSIONBCCP is a rare neoplasm different from prostate adenocarcinoma. Immunohistochemistry is indispensable in distinguishing this tumor from other types of prostatic carcinoma. Its biological behavior remains to be further studied. The best treatment option may be radical surgery combined with chemo-radiotherapy at the present time.

Aged ; Carcinoma, Basal Cell ; pathology ; Humans ; Male ; Middle Aged ; Prostatic Neoplasms ; pathology

OBJECTIVETo investigate the clinicopathologic features and immunohistochemical of the basal-like subtype of invasive breast carcinoma (BLBC), and to discuss the diagnosis standard.

METHODSImmunohistochemistry was performed in 448 cases of breast carcinoma and these cases were categorized into luminal A, luminal B, null subtypes, HER2-overexpressing and basal-like and their clinicopathologic features were observed under light microscope with stains of HE and immunohistochemical InVitrogen staining.

RESULTSAmong the breast cancer patients, the incidence of BLBC was 15.4% (69/448). Morphologic features significantly associated with BLBC constituently included nest structure and showing diffuse growth pattern, large scarring areas without cells in tumor, geographic necrosis, pushing margin of invasion, lymphocytic infiltrate in various degree in tumor stroma, syncytial tumor cell without clear boundaries, tumor cell showing vesicular unclear chromatin and nucleolus, markedly elevated mitotic count, metaplasia (all P < 0.01). Meanwhile, most BLBC showed strong immunoreactivity for CK5/6, CK14, CK17 (all P < 0.01).

CONCLUSIONBLBC showed distinct morphologic and immunophenotypic features.

Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; metabolism ; pathology ; Breast Neoplasms, Male ; metabolism ; pathology ; Carcinoma, Basal Cell ; metabolism ; pathology ; Carcinoma, Ductal, Breast ; metabolism ; pathology ; Female ; Humans ; Immunohistochemistry ; Keratin-14 ; metabolism ; Keratin-17 ; metabolism ; Keratin-5 ; metabolism ; Keratin-6 ; metabolism ; Lymphatic Metastasis ; Male ; Middle Aged ; Receptor, ErbB-2 ; metabolism ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism

BACKGROUND: Merkel cell carcinoma (MCC) is an increasingly common neuroendocrine cancer of the skin. Merkel cell polyomavirus (MCPyV) is one of the causative agents of MCC. The prevalence of MCPyV in primary MCC and sun-exposed non-MCC tumors has been known to have different results depending on where it was investigated. OBJECTIVE: This study assesses the prevalence of MCPyV from primary MCC and sun-exposed non-MCC tumors in Korea. METHODS: A molecular pathology study was performed on 7 tissue specimens of MCC, 1 tissue specimen of metastatic small cell carcinoma of the lung, and 32 tissue specimens of non-MCC tumors occurring from sun-exposed areas [8 basal cell carcinomas (BCCs), 8 squamous cell carcinomas (SCCs), 8 actinic keratoses (AKs), and 8 seborrheic keratoses (SKs)]. All specimens were analyzed to determine the presence of MCPyV-DNA using both polymerase chain reaction (PCR) and real-time quantitative PCR. Immunohistochemistry with monoclonal antibody of MCPyV large T antigen (CM2B4) was also conducted. RESULTS: Using both PCR, MCPyV sequences were detected in six of seven MCC tissue specimens (85.7%). Five (71%) of seven MCC tumors were immunoreactive for CM2B4. All five immunoreactive cases were positive for MCPyV. However, there was no association of MCPyV with BCC, SCC, AK, and SK. CONCLUSION: Our results implicate that MCPyV may contribute to the pathogenesis of primary MCC, not of non-MCC skin tumors in Korea, and the persons with MCPyV infection are unusual in Korea compared to other areas.
Antigens, Viral, Tumor ; Carcinoma, Basal Cell ; Carcinoma, Merkel Cell ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Humans ; Immunohistochemistry ; Keratosis, Actinic ; Keratosis, Seborrheic ; Korea ; Lung ; Merkel cell polyomavirus ; Pathology, Molecular ; Polymerase Chain Reaction ; Prevalence ; Skin ; Skin Neoplasms