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Basal cell carcinoma presenting as a perianal ulcer and treated with radiotherapy.

Lee HS, Kim SK - Ann Dermatol (2015)

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Ajou University School of Medicine, Suwon, Korea.

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An 83-year-old man presented with an erythematous ulcer on his perianal area for 3~4 years... The skin lesion was slowly growing, but did not cause pain or bleeding... He did not report any gastrointestinal symptoms... On examination, a single 3.0×3.0 cm-sized, erythematous, asymptomatic ulcer with raised edges was observed on the perianal area (Fig. 1A)... Radiotherapy can be a treatment option in elderly patients and those with significant medical comorbidities... In the present case, poor medical conditions and the location, which made it difficult for complete excision, rendered him unsuitable for surgery... However, patients treated with radiotherapy should be closely followed up because BCC treated with radiotherapy recurs more often than that treated with Mohs micrographic surgery; Rowe et al. reported that the 5-year recurrence rate of radiotherapy-treated disease is higher (9.8%) than that of Mohs micrographic surgery (5.6%)... Also, the potential for radiogenic toxicity in the skin should not be ignored, especially when it might cause severe functional discomfort... In summary, we describe a rare case of BCC that presented as a perianal ulcer... We also suggest considering radiotherapy in cases of BCC in the perianal area when surgical treatment is not possible.

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Initial clinical findings of basal cell carcinoma (BCC) in the perianal area. (A) Single, erythematous, asymptomatic ulcer with raised edge in the perianal area. (B) Histopathological findings. Nodular masses of basaloid cells extending into the dermis. The islands of tumor cells show a peripheral, palisading pattern and the nuclei, as a rule, have a rather uniform appearance (H&E, ×100). (C) After 17 fractions of radiotherapy over 6 weeks, the ulcerative lesion of perianal BCC shows considerable clinical improvement.
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Figure 1: Initial clinical findings of basal cell carcinoma (BCC) in the perianal area. (A) Single, erythematous, asymptomatic ulcer with raised edge in the perianal area. (B) Histopathological findings. Nodular masses of basaloid cells extending into the dermis. The islands of tumor cells show a peripheral, palisading pattern and the nuclei, as a rule, have a rather uniform appearance (H&E, ×100). (C) After 17 fractions of radiotherapy over 6 weeks, the ulcerative lesion of perianal BCC shows considerable clinical improvement.

Mentions: On examination, a single 3.0×3.0 cm-sized, erythematous, asymptomatic ulcer with raised edges was observed on the perianal area (Fig. 1A). Under the clinical impression of Paget disease or Crohn disease, punch biopsy was performed. Histopathologically, nodular masses of basaloid cells extended into the dermis and showed a peripheral palisading pattern, which were consistent with BCC (Fig. 1B).


Basal cell carcinoma presenting as a perianal ulcer and treated with radiotherapy.

Lee HS, Kim SK - Ann Dermatol (2015)

Initial clinical findings of basal cell carcinoma (BCC) in the perianal area. (A) Single, erythematous, asymptomatic ulcer with raised edge in the perianal area. (B) Histopathological findings. Nodular masses of basaloid cells extending into the dermis. The islands of tumor cells show a peripheral, palisading pattern and the nuclei, as a rule, have a rather uniform appearance (H&E, ×100). (C) After 17 fractions of radiotherapy over 6 weeks, the ulcerative lesion of perianal BCC shows considerable clinical improvement.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4377415&req=5

Figure 1: Initial clinical findings of basal cell carcinoma (BCC) in the perianal area. (A) Single, erythematous, asymptomatic ulcer with raised edge in the perianal area. (B) Histopathological findings. Nodular masses of basaloid cells extending into the dermis. The islands of tumor cells show a peripheral, palisading pattern and the nuclei, as a rule, have a rather uniform appearance (H&E, ×100). (C) After 17 fractions of radiotherapy over 6 weeks, the ulcerative lesion of perianal BCC shows considerable clinical improvement.
Mentions: On examination, a single 3.0×3.0 cm-sized, erythematous, asymptomatic ulcer with raised edges was observed on the perianal area (Fig. 1A). Under the clinical impression of Paget disease or Crohn disease, punch biopsy was performed. Histopathologically, nodular masses of basaloid cells extended into the dermis and showed a peripheral palisading pattern, which were consistent with BCC (Fig. 1B).

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Ajou University School of Medicine, Suwon, Korea.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

An 83-year-old man presented with an erythematous ulcer on his perianal area for 3~4 years... The skin lesion was slowly growing, but did not cause pain or bleeding... He did not report any gastrointestinal symptoms... On examination, a single 3.0×3.0 cm-sized, erythematous, asymptomatic ulcer with raised edges was observed on the perianal area (Fig. 1A)... Radiotherapy can be a treatment option in elderly patients and those with significant medical comorbidities... In the present case, poor medical conditions and the location, which made it difficult for complete excision, rendered him unsuitable for surgery... However, patients treated with radiotherapy should be closely followed up because BCC treated with radiotherapy recurs more often than that treated with Mohs micrographic surgery; Rowe et al. reported that the 5-year recurrence rate of radiotherapy-treated disease is higher (9.8%) than that of Mohs micrographic surgery (5.6%)... Also, the potential for radiogenic toxicity in the skin should not be ignored, especially when it might cause severe functional discomfort... In summary, we describe a rare case of BCC that presented as a perianal ulcer... We also suggest considering radiotherapy in cases of BCC in the perianal area when surgical treatment is not possible.

No MeSH data available.


Related in: MedlinePlus