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DOI: 10.5999/aps.2018.01046
Squamous cell carcinoma identified in a thick-walled epidermal cyst with a recurrent ulcer
Epidermal cysts are common skin tumors. In order to achieve cost-effectiveness, routine biopsy is not recommended in the setting of plastic surgery [1]. We report a case of squamous cell carcinoma (SCC) confirmed in a residual wound after resection of a cutaneous cyst. A 46-year-old male patient underwent local resection of a cystic lesion in the left nasal alar region 3 weeks before at a local medical center without biopsy. He developed tenderness, fever, and erythema over the wound, and visited our hospital ([Fig. 1A]). While the planned excision was performed, a 0.8×0.9-cm-thick white capsule was observed ([Fig. 2]). Therefore, a biopsy including skin tissue was performed. A SCC was then diagnosed ([Fig. 3]), and additional resection with a 5-mm safety margin was performed. During the 18-month follow-up period, no recurrence was observed ([Fig. 1B]). Owing to the rarity of SCC arising from epidermal cysts, the nature and mechanism of this phenomenon remains uncertain. Malignant change of an epidermal cyst is suspected when a chronic wound shows a sudden increase in size and ulceration. In such cases, other authors have suggested that biopsy and complete excision with a pathological examination should be performed [2]. According to a recent study, reported cases of SCC from epidermal cysts have increased [3]. Thus, to exclude malignant tumors, a biopsy is recommended when epidermal cysts with recurrent ulcers show wall thickening.
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Notes
Ethical approval
The study was approved by the Institutional Review Board of Yeungnam University Hospital (IRB No. YUMC 2018-09-026) and performed in accordance with the principles of the Declaration of Helsinki. Written informed consent was obtained.
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Patient consent
The patient provided written informed consent for the publication and the use of his images.
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Conflict of Interest
No potential conflict of interest relevant to this article was reported.
This work was supported by Yeungnam University grants in 2017.
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References
- 1 Fisher M, Alba B, Bhuiya T. et al. Routine pathologic evaluation of plastic surgery specimens: are we wasting time and money?. Plast Reconstr Surg 2018; 141: 812-6
- 2 Lee JW, Shin JY, Roh SG. et al. Squamous cell carcinoma arising from an epidermal inclusion cyst. Arch Plast Surg 2016; 43: 112-4
- 3 Frank E, Macias D, Hondorp B. et al. Incidental squamous cell carcinoma in an epidermal inclusion cyst: a case report and review of the literature. Case Rep Dermatol 2018; 10: 61-8
Correspondence
Publication History
Received: 07 September 2018
Accepted: 18 October 2018
Article published online:
28 March 2022
© 2019. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)
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References
- 1 Fisher M, Alba B, Bhuiya T. et al. Routine pathologic evaluation of plastic surgery specimens: are we wasting time and money?. Plast Reconstr Surg 2018; 141: 812-6
- 2 Lee JW, Shin JY, Roh SG. et al. Squamous cell carcinoma arising from an epidermal inclusion cyst. Arch Plast Surg 2016; 43: 112-4
- 3 Frank E, Macias D, Hondorp B. et al. Incidental squamous cell carcinoma in an epidermal inclusion cyst: a case report and review of the literature. Case Rep Dermatol 2018; 10: 61-8
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