Squamous Cell Carcinoma in Localized Scleroderma

Česká verze

Authors: V. Ďurčanská ¹; H. Jedličková ¹; O. Sláma ²; L. Velecký ³; E. Březinová ¹; V. Vašků ¹
Authors place of work: I. dermatovenerologická klinika LF MU a FN U sv. Anny v Brně ¹; Klinika komplexní onkologické péče, Masarykův onkologický ústav, Brno ²; I. patologicko-anatomický ústav, LF MU a FN u sv. Anny v Brně ³
Published in the journal: Klin Onkol 2014; 27(6): 434-437
Category: Kazuistika
doi: https://doi.org/10.14735/amko2014434

Summary

We present a case of a young 26-year-old woman, who has been suffering from localised scleroderma (morphea) for 15 years. Recently, a lesion on the dorsum of her right foot ulcerated. Based on a CT scan and X-ray a diagnosis of ulcerative osteomyellitis was established. The patient was treated with a combination of antibiotics. Subsequent histological examinations showed granulomatous tissue and chronic inflammatory changes on top of pseudoepiteliomatous hyperplasia. The patient’s status was deteriorating, which resulted in a limb amputation under the knee. Three months later, there was a metastasis of squamous cell carcinoma found in the patient‘s inguinal lymph node. In spite of combined therapy (surgery, radioterapy and systemic chemotherapy), new metastases occurred and the patient succumbed to the disease several months afterwards. The case was concluded as a squamous cell carcinoma camouflaged by osteomyelitis. Malignant turn of localised sclerodema is very rare. It usually occurs on the lower extremities of patients with a long course of the disease and is associated with pansclerotic or generalised variants of morphea.

Key words:
localized scleroderma – squamous cell carcinoma – ulcer – osteomyelitis

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Submitted:
17. 9. 2014

Accepted:
21. 10. 2014

Zdroje

1. Greco M, Kupfer‑ Bessaguet L, Delahaye JF et al. Multiple cutaneous squamous cell carcinomas arising in a patient with generalised morphea. Eur J Dermatol 2006; 16(1): 90– 91.

2. Nachbar F, Stolz W, Volkenand M et al. Squamous cell carcinoma in localised scleroderma following immunosupressive therapy with azathioprine. Acta Derm Venereol 1993; 73(3): 217– 219.

3. Frey E et al. Sklerodermie mit calcinosis der haut und symmeltrischen pflesterzell‑ karzinom. Dermatologica 1952; 105: 273.

4. Grunwald MH, Lee JY, Ackerman AB. Pseudocarcinomatous hyperplasia. Am J Dermatopathol 1988; 10(2): 96– 103.

5. Parodi PC, Riberti C, Draganic Sturio G et al. Squamous cell carcinoma arising in a patient with longstanding pansclerotic morphea. Br J Dermatol 2001; 144(2): 417– 419.

6. Copcu E. Marjolin’s ulcer: a preventible complication of burns? Plast Reconstr Surg 2009; 124(1): 156e‑ 164e. doi: 10.1097/ PRS.0b013e3181a8082e.

7. Saleh DB, Wiliams AM, Smith IM. Cutaneous squamous cell carcinoma arising within generalised morphea. J Plast Reconstr Aesthet Surg 2011; 64(6): e149– e152. doi: 10.1016/ j.bjps.2011.01.019.

8. Petrov I, Gantcheva M, Miteva L et al. Lower lip squamous cell carcinoma in disabling panclerotic morphea of childhood. Pediatr Dermatol 2009; 26(1): 59– 61. doi: 10.1111/ j.1525‑ 1470.2008.00823.x.

9. Wollina U, Buslau M, Heinig M et al. Disabling pansclerotic morphea of childhood poses a high risk of chronic ulceration of the skin ang squamous cell carcinoma. Int J Low Extrem Wounds 2007; 6(4): 291– 298.

10. Laux B, Braquninger W. Developement of a squamous cell carcinoma in generallised morphea. Z Hauktr 1985; 60(10): 767– 768, 771– 773.

11. Kotwal M, Poflee S, Bobhate S. Carcinoma cuniculatum at various anatomical sites. Indian J Dermatol 2005; 50(4): 216– 220.

12. Rinker MH, Fenske NA, Scalf LA et al. Histologic variants of squamous cell carcinoma of the skin. Cancer control 2001; 8(4): 354– 363.