Concomitant Squamous Cell Carcinoma and Mycosis Fungoides Within the Same Lesion: A Case Report and Literature Review.

IF 1.1 4区医学 Q4 DERMATOLOGY

American Journal of Dermatopathology Pub Date : 2025-06-01 Epub Date: 2025-04-22 DOI:10.1097/DAD.0000000000002975

Apoorva Mehta, Anna Bowling, Emily R Gordon, Oluwaseyi Adeuyan, Brigit A Lapolla, Alejandro Gru, Larisa J Geskin

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引用次数: 0

Abstract

Abstract: Concomitant squamous cell carcinoma (SCC) and mycosis fungoides (MF) within the same lesion are exceedingly rare, with only 3 cases previously reported. Cutaneous T-cell lymphoma (CTCL) predisposes patients to malignancies because of immune dysregulation, and treatments such as narrow-band ultraviolet-B phototherapy increase carcinogenic risk. We describe a 78-year-old man with stage IVA1 CTCL who presented with a scaly, painful tumor on his left temple. Biopsy revealed well-differentiated SCC with atypical lymphoid infiltrate consistent with MF, marked by immunohistochemical positivity for CD3, CD5, CD30, and a CD4:CD8 ratio of 50:1. Mohs surgery was performed, and histopathology analysis confirmed the coexistence of SCC and MF, with greater loss of CD7 expression in atypical lymphocytes. Concurrent SCC and MF demonstrate the need for vigilant surveillance for secondary cutaneous malignancies in patients with advanced CTCL. The case presented herein contributes to expand the reported literature and highlights the necessity of individualized management strategies optimized on an individual's Fitzpatrick skin type and unique risk factors.

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鳞状细胞癌和蕈样真菌病在同一病灶内合并：1例报告并文献复习。

摘要：鳞状细胞癌（SCC）和蕈样真菌病（MF）在同一病变内合并极为罕见，文献报道仅有3例。由于免疫失调，皮肤t细胞淋巴瘤（CTCL）使患者易患恶性肿瘤，而窄带紫外线b光疗等治疗增加了致癌风险。我们描述了一位78岁的IVA1期CTCL患者，他的左太阳穴出现鳞片状，疼痛的肿瘤。活检显示分化良好的鳞状细胞癌伴非典型淋巴浸润，与MF一致，CD3、CD5、CD30免疫组化阳性，CD4:CD8比值为50:1。进行Mohs手术，组织病理学分析证实SCC和MF共存，非典型淋巴细胞中CD7表达的损失更大。并发SCC和MF表明需要对晚期CTCL患者继发性皮肤恶性肿瘤进行警惕监测。本文提出的病例有助于扩大文献报道，并强调了针对个体菲茨帕特里克皮肤类型和独特风险因素优化个性化管理策略的必要性。

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

American Journal of Dermatopathology 医学-皮肤病学

CiteScore

1.80

自引率

9.10%

发文量

453

审稿时长

3 months

期刊介绍： The American Journal of Dermatopathology offers outstanding coverage of the latest diagnostic approaches and laboratory techniques, as well as insights into contemporary social, legal, and ethical concerns. Each issue features review articles on clinical, technical, and basic science advances and illuminating, detailed case reports. With the The American Journal of Dermatopathology you''ll be able to: -Incorporate step-by-step coverage of new or difficult-to-diagnose conditions from their earliest histopathologic signs to confirmatory immunohistochemical and molecular studies. -Apply the latest basic science findings and clinical approaches to your work right away. -Tap into the skills and expertise of your peers and colleagues the world over peer-reviewed original articles, "Extraordinary cases reports", coverage of practical guidelines, and graphic presentations. -Expand your horizons through the Journal''s idea-generating forum for debating controversial issues and learning from preeminent researchers and clinicians