Keratoacanthoma Centrifugum Marginatum With Spontaneous Regression And Its Possible Differential Diagnosis
Amagai, R., Fujimura, T., Kambayashi, Y., Furudate, S., Sato, Y., Tanita, K., Hashimoto, A., & Aiba, S. (2018). Keratoacanthoma Centrifugum Marginatum with Spontaneous Regression and Its Possible Differential Diagnosis. Case reports in oncology, 11(3), 671–675. https://doi.org/10.1159/000493089
View Original Source →Abstract
Keratoacanthoma centrifugum marignatum (KCM) is a rare variant of keratoacanthoma, which is characterized by the dense infiltration of inflammatory cells throughout the dermis, especially around the keratinocytic islands. Therefore, it is sometimes difficult to differentiate between KCM and cutaneous T-cell lymphomas. In this report, we describe a case of KCM with spontaneous regression that showed dense infiltration of CD3+CD8+ T cells. Our present case suggested the importance of investigating tumor-infiltrating lymphocytes to avoid the misdiagnosis of KCM as cutaneous T-cell lymphoma.
Case Details
Disease Location
Skin
Personal Characteristics
26-year-old japanese female
Clinical Characteristics
1-month history of an asymptomatic nodule on the upper arm. Physical examination revealed a red nodule with a central ulceration, 50 × 50 mm in size, on the upper arm. Biopsy specimen showed islands of keratinocytes with squamous pearls, pseudoepitheliomatous hyperplasia, and dense infiltration of inflammatory cells throughout the dermis. These keratinocytic islands were composed of well-differentiated squamous epithelium with a mild degree of pleomorphism, individual cell keratinization, and keratin pearls. In addition, immunohistochemical staining revealed that these infiltrating cells were mainly composed of CD3+, CD8+, t cells. The tumor was excised. Histological findings of the resected tumor showed well-differentiated squamous epithelium surrounded by dense infiltration of neutrophils, plasma cells, and lymphocytes. Final diagnosis was kcm with spontaneous regression
Remission Characteristics
Her nodule rapidly regressed with hyperkeratosis, central depression and prominent erythema around the tumor
Treatment & Mechanisms
Proposed Remission Mechanisms
Antitumor immune response was suppressed at the tumor site.
Clinical Treatment
Biopsy surgical excision