1/17. A case of giant keratoacanthoma of the auricle.Although keratoacanthomas are not rare in the head and neck area, patients with this type of tumor rarely consult an otolaryngologists for treatment. keratoacanthoma should be considered in the differential diagnosis of squamous cell carcinoma. This tumor grows rapidly, usually attaining a size of about 10-20 mm in approximately 6 weeks. This is followed by slow involution over a period of 2-6 months. A keratoacanthoma larger than 20-30 mm is called as 'giant keratoacanthoma' and it is scarce. We encountered a case of giant keratoacanthoma (50 mm in diameter) on the right auricle of 84-year-old Japanese woman with a 3-year history of gradual tumor growth. Several clinical and histopathological factors made the diagnosis difficult. The tumor was completely removed by surgery and diagnosed as a keratoacanthoma by histopathological examination.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/17. Malignant changes in a giant orbital keratoacanthoma developing over 25 years.PURPOSE: To report a patient with a history over 25 years of a slowly growing, large, invasive crateriform tumour filling the anterior part of the orbit. methods: A 61-year-old male presented with a large tumour of the left orbit. Exenteration was performed with subsequent histological analysis of the excised mass. RESULTS: The main tumour showed the characteristic features of a keratoacanthoma. However, the posterior aspect of the tumour disclosed the morphology of a squamous cell carcinoma. Six months later, the patient presented with metastases to lymph nodes, lung and mediastinal tissue. A leukemoid reaction was diagnosed by fine needle biopsy. CONCLUSION: The giant variety of keratoacanthoma may fail to regress and can transform into a squamous cell carcinoma. In our patient, the development of a chronic lymphoid leukemia raises the possibility that it may be the underlying cause for the transformation of the posterior part of the keratoacanthoma into a frank squamous cell carcinoma.- - - - - - - - - - ranking = 0.83333333333333keywords = giant (Clic here for more details about this article) |
3/17. Intralesional methotrexate as effective treatment in solitary giant keratoacanthoma of the lower lip.When size and location of a keratoacanthoma along with patient-related factors argue against surgical treatment, intralesional methotrexate shows to be an effective, easy and inexpensive alternative. The case report presented validates this treatment modality.- - - - - - - - - - ranking = 0.66666666666667keywords = giant (Clic here for more details about this article) |
4/17. Giant keratoacanthoma arising in hypertrophic lichen planus.A 45-year-old man presented with a rapidly enlarging tumour in an area of long-standing hypertrophic lichen planus of the lower leg. Histological examination of the resected specimen showed it to be a giant keratoacanthoma measuring 37 x 57 mm. Neoplastic change is a rarely reported complication of chronic variants of cutaneous lichen planus. To date there have been only two reports of keratoacanthoma development in association with lichen planus.- - - - - - - - - - ranking = 0.16666666666667keywords = giant (Clic here for more details about this article) |
5/17. Combined 5-fluorouracil and Er:YAG laser treatment in a case of recurrent giant keratoacanthoma of the lower leg.BACKGROUND: Keratoacanthomas are fast-growing squamous tumors, which usually show spontaneous regression. The development of giant variants with an aggressive behavior has been described. Although surgical excision remains the treatment of choice for very large keratoacanthomas, other therapeutic options including laser surgery and topical chemotherapy may be superior in special situations. OBJECTIVE: The objective was to evaluate the efficacy of Er:YAG laser surgery combined with topical 5-fluorouracil treatment in a case of recurrent giant keratoacanthoma. methods: A 64-year-old woman presented for evaluation and treatment of recurrent tumors in her face and extremities. Despite repeated invasive surgical removal of these lesions, recurrence of fast-growing giant keratoacanthomas developed in the pretibial region of her left lower leg. Owing to recurrence after conventional surgery and the tumor size, a novel treatment method using ablative Er:YAG laser combined with topical 5-fluorouracil was performed. RESULTS: After four treatments with excellent patient compliance, histologic analysis of punch biopsies revealed tumor-free ulcerations. Complete epithelization was obtained after 9 weeks. Six months after the treatment, no recurrence was observed. CONCLUSION: The combined use of ablative Er:YAG laser and topical 5-fluorouracil chemotherapy may be considered as an effective treatment option in cases of giant keratoacanthoma when conventional surgery is not indicated.- - - - - - - - - - ranking = 1.3333333333333keywords = giant (Clic here for more details about this article) |
6/17. keratoacanthoma centrifugum marginatum accompanied by extensive granulomatous foreign body reaction.We describe a 58-year-old woman with a 4-year history of papular lesions with a partly verruciform appearance on the eyelids and the adjacent areas of the nose. The lesions progressed slowly but constantly into the surrounding areas with central scarring. Histopathology showed epidermal endophytic proliferations under a pronounced hyperparakeratosis. In the adjacent dermis a lymphohistiocytic infiltrate with giant cells of the foreign-body-reaction type was seen in close contact to extracellular keratin deposits. Although some cytopathological signs typical for viropathic effects were observed, no human papilloma virus-dna was detected within the lesions by polymerase chain reaction. According to the histological picture and the clinical course we diagnosed a keratoacanthoma centrifugum marginatum. We present this case because of the strong granulomatous foreign body reaction which might complicate the diagnosis and has not been described for this keratoacanthoma variant so far.- - - - - - - - - - ranking = 0.16666666666667keywords = giant (Clic here for more details about this article) |
7/17. Giant keratoacanthoma of the hand.Giant keratoacanthoma (KA) is a very rare tumor which benefits of surgical treatment. We present a case of 61-years-old man with a giant keratoacanthoma situated on the dorsum of the right hand. The diagnosis is established by routine histopathologic examination.- - - - - - - - - - ranking = 0.16666666666667keywords = giant (Clic here for more details about this article) |
8/17. HPV 6-positive giant keratoacanthoma in an immunocompetent patient.keratoacanthoma (KA) is a clinically distinct, rapidly growing lesion that generally presents as a solitary crateriform nodule in sun-exposed areas in elderly, fair-skinned individuals. A KA larger than 20-30 mm is referred to as giant keratoacanthoma, a relatively rare lesion especially in young patients. Such lesions grow rapidly with possible destruction of underlying tissues. In addition to ultraviolet exposure, KAs have also been associated with chemical carcinogens, chemical peels, genetic factors, chronic skin conditions that produce scarring, trauma and thermal burns. Immunosuppressed patients, especially after transplantation, also develop KAs. A viral etiology has been suggested but not confirmed. We encountered a case of giant keratoacanthoma (greater than 50 mm in diameter) with induration of underlying structures on the upper lip of a 39-year-old male sailor. The patient reported sudden appearance and rapid enlargement of the lesion in only three weeks. biopsy of the cutaneous lesion and the characteristic clinical history suggested the diagnosis of keratoacanthoma. Total excision with primary closure of the defect by a nasolabial advancement flap was performed. Histological examination of the tumor mass confirmed the diagnosis of KA with infiltrative growth and perineural invasion. immunosuppression was excluded by blood analyses, as were hiv, syphilis and hepatitis infections. Only low-risk genital HPV type 6 was detected in the lesion, suggesting a possible cocarcinogenic effect of HPV and UV light in a chronically sun-exposed patient.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
9/17. Treatment of giant keratoacanthoma with intralesional 5-fluorouracil.Giant keratoacanthomas measure greater than 2 cm and have a predilection for the nose and eyelids. As a result, they often present a significant therapeutic challenge. A 36-year old woman was referred for evaluation of a 4.0 x 4.0 cm giant keratoacanthoma on the nose. The patient was treated with intralesional 5-fluorouracil, and the tumor underwent complete regression leaving a full thickness nasal cleft. The defect was then reconstructed with a paramedian forehead flap with good cosmesis.- - - - - - - - - - ranking = 0.83333333333333keywords = giant (Clic here for more details about this article) |
10/17. Surgical treatment for aggressive giant keratoacanthoma of the face.A case of aggressive giant keratoacanthoma on the right temple region is described. Histopathologic examination was not definitive for keratoacanthoma, so that clinical considerations were helpful for diagnosis. The neoplasm was treated successfully with surgical excision and immediate repair with skin graft, in spite of one narrow peripheral area of residual disease on the wound surface after resection.- - - - - - - - - - ranking = 0.83333333333333keywords = giant (Clic here for more details about this article) |
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