Vulvar keratoacanthoma may be a malignant precursor: A case report and literature review

IF 1.2 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports Pub Date : 2025-02-01 DOI:10.1016/j.gore.2024.101674

Fang Chen , Yang Wang , Dina Haishaer , Feng Bai

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引用次数: 0

Abstract

Background

Keratoacanthoma is a relatively rare skin tumor, with vulvar keratoacanthoma being even more uncommon. Although the majority of keratoacanthomas exhibit a benign course, a subset of cases may show features of malignant potential, such as marginal invasion and recurrence.

Case

An 82-year-old female presented with a rapidly growing exophytic lesion on the left vulva, measuring 1.5 cm in diameter, accompanied by pruritus. The lesion had been present for two months. The patient underwent vulvar mass excision, and postoperative pathology revealed squamous cell hyperplasia with glassy cytoplasm and no significant cellular atypia. The surgical margins were clear. Three years later, the tumor recurred with disordered growth.

Conclusion

In terms of histological and clinical presentation, keratoacanthoma may overlap with classical well-differentiated squamous cell carcinoma. In rare cases, certain atypical keratoacanthomas may exhibit intravascular and perineural invasion, along with lymph node metastasis. By sharing our treatment experience of a patient with recurrent vulvar keratoacanthoma following surgery, we aim to provide a cautionary perspective for the clinical management of such cases.

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外阴角棘瘤可能是恶性肿瘤的前兆：1例报告及文献复习。

背景：角棘瘤是一种较为罕见的皮肤肿瘤，外阴角棘瘤更为少见。虽然大多数角棘瘤表现为良性过程，但也有一部分病例可能表现出潜在的恶性特征，如边缘侵袭和复发。病例：82岁女性，左侧外阴快速生长的外生性病变，直径1.5 cm，伴有瘙痒。病变已经存在了两个月。患者行外阴肿块切除术，术后病理显示鳞状细胞增生，胞质呈玻璃状，无明显的细胞异型性。手术边缘清晰。三年后，肿瘤复发，生长紊乱。结论：在组织学和临床表现方面，角棘瘤可能与典型的高分化鳞状细胞癌重叠。在极少数情况下，某些非典型角棘瘤可能表现为血管内和神经周围浸润，并伴有淋巴结转移。通过对一例外阴角棘瘤术后复发患者的治疗经验，为此类病例的临床治疗提供参考。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gynecologic Oncology Reports OBSTETRICS & GYNECOLOGY-

CiteScore

2.00

自引率

0.00%

发文量

183

审稿时长

41 days

期刊介绍： Gynecologic Oncology Reports is an online-only, open access journal devoted to the rapid publication of narrative review articles, survey articles, case reports, case series, letters to the editor regarding previously published manuscripts and other short communications in the field of gynecologic oncology. The journal will consider papers that concern tumors of the female reproductive tract, with originality, quality, and clarity the chief criteria of acceptance.