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Giant cell temporal arteritis associated with overlying basal cell carcinoma: co-incidence or connection?

Mahe E, Demellawy DE, Bane A, Alowami S - Rare Tumors (2012)

Bottom Line: Giant cell arteritis is a granulomatous vasculitis of large and medium sized arteries manifesting as temporal arteritis and/or polymyalgia rheumatica.The histological assessment of temporal artery biopsies is frequently encountered in anatomical pathology and has important diagnostic consequences in patients clinically suspected of having giant cell arteritis.We present an intriguing case of giant cell arteritis associated with a Basal cell carcinoma and discuss the ongoing controversy pertaining to the association of giant cell arteritis/polymyalgia rheumatica with malignancy.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology and Molecular Medicine, Hamilton Health Sciences, McMaster University, Hamilton;

ABSTRACT
Giant cell arteritis is a granulomatous vasculitis of large and medium sized arteries manifesting as temporal arteritis and/or polymyalgia rheumatica. The histological assessment of temporal artery biopsies is frequently encountered in anatomical pathology and has important diagnostic consequences in patients clinically suspected of having giant cell arteritis. We present an intriguing case of giant cell arteritis associated with a Basal cell carcinoma and discuss the ongoing controversy pertaining to the association of giant cell arteritis/polymyalgia rheumatica with malignancy.

No MeSH data available.


Related in: MedlinePlus

A) Basal cell carcinoma (Hematoxylin and Eosin, 40×); B) giant-cell arteritis (Hematoxylin and Eosin, 100×); C) giant-cell arteritis (Elastic Van-Gieson, 100×).
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Related In: Results  -  Collection


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Figure 2: A) Basal cell carcinoma (Hematoxylin and Eosin, 40×); B) giant-cell arteritis (Hematoxylin and Eosin, 100×); C) giant-cell arteritis (Elastic Van-Gieson, 100×).

Mentions: An eighty three year old male presented to his primary care physician with a left temporal non-traumatic, ulcerating lesion. In the three months prior to his presentation, he had also noted periodic intense unilateral headaches, vague symptoms reminiscent of jaw claudication as well as increasing proximal muscle pain in his upper limbs. The patient did not, however, note any vision changes or neurologic symptoms. The skin lesion to his left temple was clinically consistent with a basal cell carcinoma and he was subsequently referred to a plastic surgeon for surgical resection. In the interim, to investigate his headaches and other symptoms, the patient's family doctor requested a magnetic resonance image of his brain, which noted only age-related changes. Excision of the left temple lesion revealed an ulcerating basal cell carcinoma (Figure 1), clear of the surgical margins of resection. In addition, a portion of presumed temporal artery noted at the periphery of the primary lesion showed mural-based granulomatous inflammation associated with fibrinoid necrosis obliterating the internal and external arterial elastic laminae (Figure 2). The case was diagnosed as left temple basal cell carcinoma with concomitant giant cell arteritis. The patient received immediate steroid therapy and is well after 2 years of follow-up.


Giant cell temporal arteritis associated with overlying basal cell carcinoma: co-incidence or connection?

Mahe E, Demellawy DE, Bane A, Alowami S - Rare Tumors (2012)

A) Basal cell carcinoma (Hematoxylin and Eosin, 40×); B) giant-cell arteritis (Hematoxylin and Eosin, 100×); C) giant-cell arteritis (Elastic Van-Gieson, 100×).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3475953&req=5

Figure 2: A) Basal cell carcinoma (Hematoxylin and Eosin, 40×); B) giant-cell arteritis (Hematoxylin and Eosin, 100×); C) giant-cell arteritis (Elastic Van-Gieson, 100×).
Mentions: An eighty three year old male presented to his primary care physician with a left temporal non-traumatic, ulcerating lesion. In the three months prior to his presentation, he had also noted periodic intense unilateral headaches, vague symptoms reminiscent of jaw claudication as well as increasing proximal muscle pain in his upper limbs. The patient did not, however, note any vision changes or neurologic symptoms. The skin lesion to his left temple was clinically consistent with a basal cell carcinoma and he was subsequently referred to a plastic surgeon for surgical resection. In the interim, to investigate his headaches and other symptoms, the patient's family doctor requested a magnetic resonance image of his brain, which noted only age-related changes. Excision of the left temple lesion revealed an ulcerating basal cell carcinoma (Figure 1), clear of the surgical margins of resection. In addition, a portion of presumed temporal artery noted at the periphery of the primary lesion showed mural-based granulomatous inflammation associated with fibrinoid necrosis obliterating the internal and external arterial elastic laminae (Figure 2). The case was diagnosed as left temple basal cell carcinoma with concomitant giant cell arteritis. The patient received immediate steroid therapy and is well after 2 years of follow-up.

Bottom Line: Giant cell arteritis is a granulomatous vasculitis of large and medium sized arteries manifesting as temporal arteritis and/or polymyalgia rheumatica.The histological assessment of temporal artery biopsies is frequently encountered in anatomical pathology and has important diagnostic consequences in patients clinically suspected of having giant cell arteritis.We present an intriguing case of giant cell arteritis associated with a Basal cell carcinoma and discuss the ongoing controversy pertaining to the association of giant cell arteritis/polymyalgia rheumatica with malignancy.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology and Molecular Medicine, Hamilton Health Sciences, McMaster University, Hamilton;

ABSTRACT
Giant cell arteritis is a granulomatous vasculitis of large and medium sized arteries manifesting as temporal arteritis and/or polymyalgia rheumatica. The histological assessment of temporal artery biopsies is frequently encountered in anatomical pathology and has important diagnostic consequences in patients clinically suspected of having giant cell arteritis. We present an intriguing case of giant cell arteritis associated with a Basal cell carcinoma and discuss the ongoing controversy pertaining to the association of giant cell arteritis/polymyalgia rheumatica with malignancy.

No MeSH data available.


Related in: MedlinePlus