Dataset Information

Surgical excision of a giant solitary keratoacanthoma in the cheek: a case report and literature review.

ABSTRACT:

Background

Giant keratoacanthoma, a rare variant solitary of keratoacanthoma is characterized by a diameter exceeding 20 mm, rapid growth, and destruction of underlying tissue. Traditionally, it has been considered to be a self-resolving or low-grade squamous proliferation. Due to their atypical appearance, Giant keratoacanthomas may present a diagnostic challenge. Histopathological examination remains the reference standard for distinguishing squamous cell carcinoma (SCC) from keratoacanthoma. Surgical management is still the standard treatment for solitary keratoacanthoma.

Case description

We present the case of a 75-year-old man with a giant keratoacanthoma of the cheek, with a transverse length of 25 mm and a longitudinal length of 30 mm located 30 mm below the earlobe that was surgically excised with no obvious recurrence during follow-up. We used the Intraoperative frozen-section examination, which played a crucial role in ensuring clear margins and complete tumor removal.

Conclusions

This case demonstrates that keratoacanthoma can be considered surgically curable and should be distinguished from SCC and other crateriform tumors. After surgical resection of giant isolated keratoacanthoma on the face, the high risk of cosmetic problems should be considered. We suggest free-flap transplantation be performed for functional repair, when the invasion range of the tumor is large and a perforation defect is formed.

SUBMITTER: Ni Y

PROVIDER: S-EPMC10789903 | biostudies-literature | 2024

REPOSITORIES: biostudies-literature

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Publications

Surgical excision of a giant solitary keratoacanthoma in the cheek: a case report and literature review.

Ni Yazhuo Y Li Rui R Zhu Dongwang D Dong Rui R Qiao Feng F

AME case reports 20231201

<h4>Background</h4>Giant keratoacanthoma, a rare variant solitary of keratoacanthoma is characterized by a diameter exceeding 20 mm, rapid growth, and destruction of underlying tissue. Traditionally, it has been considered to be a self-resolving or low-grade squamous proliferation. Due to their atypical appearance, Giant keratoacanthomas may present a diagnostic challenge. Histopathological examination remains the reference standard for distinguishing squamous cell carcinoma (SCC) from keratoaca ...[more]

PMID: 38234361

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Project description:RationaleCellular angiofibroma (CA) is a rare tumor of the soft tissue classified as a benign fibroblastic/myofibroblastic tumor. Considering this, the literature regarding CA mainly, but not exclusively, comprises single case reports and case series. Here, we report a case of giant CA of the vulva with comprehensive literature review.Patient concernsWe present a case of a massive vulvar CA arising in 53-year-old woman with no notable medical or surgical history. The mass has grown considerably over time, causing pain and difficult urination, defecation, and movement. The patient had normal regular menstrual cycle with no previous contraception use. Vaginal examination exposed a right-sided large tender vulvar mass with normal-looking vagina.DiagnosesPelvic magnetic resonance imaging with contrast revealed a large right vulvar heterogeneously enhancing soft tissue mass measuring 13.1 × 10.9 × 10.7 cm expending the left vulva, with internal and peripheral voids resembling feeding vessels. The mass was surgically removed, and subsequent histopathology showed skin-covered dermal-based lesion composed of fibroblast-like bland and spindle cell proliferation with thin-walled blood vessels of various sizes. Immunohistostaining of CD34 and smooth muscle antigen were both positive, while desmin was found to be negative. A diagnosis of vulvar angiofibroma was made based on the clinical scenario, imaging, and histopathology.InterventionsMass vulvectomy was performed starting with a circumferential incision at the base of the mass and structural dissection to separate the mass from the vulvar wall. The incision was successfully closed, and subcuticular stitches were applied to the skin.OutcomesThe patient's complaints were significantly relieved with no postoperative complications and the patient is being followed regularly in an outpatient setting.LessonsDue to its extremely benign nature of CA, and the implausible ability of its recurrence, it was decided to surgically excise it. Despite its rarity, it can be readily identified at its earlier stages preventing the vexing and exasperating symptoms accompanied with increased size as mentioned.

Project description:IntroductionPericardial cysts are considered as a rare congenital abnormality, mostly found incidentally. The estimated incidence of pericardial cyst is 1:100,000 and represent approximately 6% of all mediastinal masses. Patients can present with symptoms similar to acute chest pain or right-sided heart failure or can be asymptomatic.PresentationA 46-year-old female who is known to have hypertension and hypothyroidism presented to the breast clinic with left breast mass that was proved by core needle biopsy as proliferative breast lesion. During the preoperative assessment, the patient reported progressive shortness of breath and cough over the last two years and bilateral lower limb edema. Her preoperative chest X-ray showed a well-defined oval like opacification at the right cardiophrenic angle that was proved by chest computed tomography imaging as a cystic mass od most likely a pericardial origin. A huge pericardial cyst originating from the right diaphragmatic surface was excised through a mini-sternotomy incision with smooth postoperative recovery. The patient-reported significant improvement in her symptoms and her lifestyle during her follow up.DiscussionPericardial cysts represent 6%-7% of all mediastinal masses with an estimated incidence of 1:100,000. About 70% of pericardial cysts originate at the right cardiophrenic angle and less frequently at the left cardiophrenic angle, they are usually suspected when the chest x-ray shows an enlarged contour of the right heart border. Mediastinal cysts have many differential diagnoses and the preoperative decision might be challenging in many cases. Pericardial cysts appear as oval, thin-walled homogeneous masses on cardiac computed tomography. The choice between surgical intervention and conservative follow up is related mainly to the size and symptoms that are induced by the cyst.ConclusionAs pericardial cysts are rarely diagnosed pathology, a high index of suspicion is essential for diagnosis. Surgical resection is indicated when they are huge, enlarging in size or symptomatic. Morbidity and mortality risks following pericardial cyst excision are very low.

Dataset Information

Surgical excision of a giant solitary keratoacanthoma in the cheek: a case report and literature review.

Background

Case description

Conclusions

Publications

Surgical excision of a giant solitary keratoacanthoma in the cheek: a case report and literature review.

Similar Datasets

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