Cutaneous Lymphoblastoma: report of two Cases with Unusual Courses

Case Details

Disease Location

Cutaneous (face) genital area

Personal Characteristics

26 -year-old female

Clinical Characteristics

First tumors appeared 5 months before her first consultation the tumor was together with another one which never reached a size bigger than a large pea, which regressed leaving small round superficial scars. At the same time, new tumors kept appearing she had two tumors on her face - one on the forehead and one on the chin each tumor waas approx. 2cm high with the diameter at the base of 2.5cm, the skin overlying the tumors was partly covered with sero-sanguinous crusts. The tumors rose clearly above the skin surface with little surrounding infiltration. The other tumors present were not bigger than large split pea size according to the patient and never reached the size of the tumors on the face regional lymphadenopathy of the tumors of the face was present, the patient reported that the regional lymphadenopathy also follwed the evolution of other tumors a preliminary diagnosis of atypical keratoacanthomas was made she was given antibiotics and a biopsy of the chin tumor was done histologic exam showed a partially destroyed and crust replaced epidermis, a great number of cells with uniform appearance with evidence of syneytium formation the cells possessed large oval pale nuclei with a distinct nuclear membrane, reniform nuclei and mitotic figures were rarely seen the border of the cytoplasm was irregular in outline, reminiscent of amoeboid shape. Evidence of retiuclin fibers. Scattered, immature, reticulum cells with large cytoplasm and nuclei, fine, reticulated nucleoplasm and nucleoli were seen while other tumors showed involution, a new fast growing tumor with distended situated in the genital area swelling of the regional lymph glands was also noted during her stay, she experience occasional fevers with occasional chills that lasted for several days a temporary rise in the wbc was occasionally seen, but nothing abnormal. Erythrocyte sedimentation rate was constantly high two months later, the patient was admitted with right pre-auricular infiltration, size 5x6cm; the infiltration was erythematous and painful. Regional lymph glands were swollen deep x-ray was used tumor growth were exophytic, except the last one which was intradermal and infiltrating

Remission Characteristics

Healing of the curetted tumor was observed; lymph glands also became smaller the curettage of the forehead tumor had the same clinical and pathohistological result the genital tumor was curetted and soon recurred only on one site, while the other part formed a scar; a second curettage brought complete healing no new tumor was seen and she was discharged 2 months after admission the right-reauricular infiltrate gradually completely thawed and the lymph glands shrank after the deep x-ray the patient comes for 2 monthly regular exams, at the time of last exam - 1 year after the last tumor appearance, no new tumor had appeared, all tests were normal

Treatment & Mechanisms

Proposed Remission Mechanisms

Progressive fibrosis was also the probably cause of the small tumor an inflammatory process often precedes sr

Clinical Treatment

Antibiotics

Non-Clinical Treatment

None reported