Ferhat Özden, İbrahim Serdar Coşkun, İhsan Kasapgil
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引用次数: 0
Abstract
Background: Collision tumors combining basal cell carcinoma (BCC) and melanoma are exceptionally rare, and their distinction from melanoma colonization remains controversial.
Case presentation: A 68-year-old man presented with a persistent ulcer on the lower lip, initially believed to represent BCC. Wedge resection revealed a 2.2 cm ulcerated lesion composed of BCC with malignant melanocyte colonization. Immunohistochemical analysis confirmed the biphasic nature: the melanocytic component was positive for S100, Melan-A, SOX10, and PRAME (with p16 loss), and the epithelial component was positive for p40 and Bcl-2. The melanoma measured 7.5 mm in Breslow thickness (pT4b) with ulceration and perineural invasion, but no lymphovascular involvement. Margins were negative. A sentinel lymph node biopsy was recommended but was declined by the patient.
Conclusion: This case illustrates the diagnostic complexity and clinical effect of BCC-melanoma collision/colonization tumors. Prognosis is dictated by the melanoma component, underscoring the need for meticulous histopathologic evaluation and immunohistochemistry in guiding patient management.
背景：碰撞肿瘤合并基底细胞癌（BCC）和黑色素瘤是非常罕见的，它们与黑色素瘤定植的区别仍然存在争议。病例介绍：一名68岁男性，下唇持续性溃疡，最初认为是基底细胞癌。楔形切除显示一个2.2厘米的溃疡病变，由恶性黑素细胞定植的BCC组成。免疫组化分析证实了双相性：黑素细胞成分为S100、Melan-A、SOX10和PRAME阳性（p16缺失），上皮成分为p40和Bcl-2阳性。黑素瘤的brreslow厚度为7.5 mm (pT4b)，伴有溃疡和神经周围浸润，但未累及淋巴血管。利润率为负。建议前哨淋巴结活检，但被患者拒绝。结论：本病例说明了bcc -黑色素瘤碰撞/定植肿瘤的诊断复杂性和临床效果。预后由黑色素瘤组成部分决定，强调在指导患者管理时需要细致的组织病理学评估和免疫组织化学。
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.
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