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Basal and squamous cell carcinomas in patients affected by chronic lymphocytic leukaemia (CLL)
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healed, 71% after WI, 42% after R3, 23% after B3 and 20% after cryo. We found no significant difference between W3 and W 1 (p = 0.84), however, significantly more warts were completely healed after W3 than after R3, B3 and cryo (p c 0.01). respectively. Significantly more warts were healed with WI (p -Z 0.01) and R3 (p c 0.03) than by cryo (p = 0.78) and between R3 and B3 (p = 0.14). We conclude: ALA-PDT is a promising therapy for warts.
FC24. FC24-1
Skin cancer 1 Embryonal rhabdomyosarcoma multiple skin metastases
Serbia, Yugoslavia; of Cardi Wales
t Institute
with the
for
Pathology,
We present a case of embryonal rhabdomyosarcoma with multiple skin metastases in a 2 month old female infant. Soon after birth the rapid painless enlargement of the right eye occurred. Several weeks later skin lesions developed. Physical examination revealed violaceous, firm dermal and subcutaneous nodules on the lower trunk, buttocks, and thighs. Skin biopsy disclosed ill-defined, dense aggregates of poorly differentiated round tumor cells. Tumor cells were positive for desmin, vimentin and muscle specific actin. CT scan demonstrated retrobulbar orbital mass with the extension to the right maxillary sinus and the base of the skull altogether with multiple visceral metastases. The patient succumbed despite chemotherapy started about a week after the diagnosis. Rhabdomyosarcoma is the most common soft tissue tumor of the pediatric population. Cutaneous metastases are extremely rare and present a bad prognostic sign. Multiple dermal or subcutaneous nodules may sometimes present as “blueberry muffin”-like syndrome. Other small round cell tumors to be considered in the differential diagnosis are neuroblastoma, hematolymphoid infiltrates, Ewing sarcoma, primitive neuroectodermal tumor and malignat melanoma FC24-2
Basal and squamous cell carcinomas in patients affected by chronic lymphocytic leukaemia (CLL)
U. Bottoni, F.R. Mauro’, A. Latini, P. Bonaccorsi, D. Innocenzi, E Mandelli’, S. Calvieri. Department of Dermatology; ‘Department of Haematology, University Rome
“La Sapienza”,
Rome,
Skin cancer
s171
1
(XC). These tumours wtre multiple in 4 cases. BCC and SCC are found in 2.6% of patients with CLL and account for 26.5% of all secondary turnours. They are more frequent in patients under antitumoral therapy: 20 out of 26 patients. The aggressive behaviour of skin epithelial cancer in patients with CLL can be explained by both the antiproliferative therapy and the immunosuppression induced by the haematological disorder. of the head in HIV+ patient I FC24 3 Angiosarcoma U. Bottoni, D. Innocenzi, G. Pranteda, P. Bonaccorsi, A. Latini, A. Richetta, V, Silipo, S. Calvieri. Department of Dermatology, University of Rome “La Sapienza”, Rome, Italy
A. Krunic, G. Vujanic’, V. Petronic-Rosic, D. Grkinic, D. Djeric, S. Vesic, M. Gajic. Institute for Dermatology, Belgrade, University
FC24.
of
Italy
In patients with chronic lymphocytic leukaemia (CLL) the risk of developing a secondary neoplasia is considered to be 8 times higher than in general population. Among secondary tumours epithelial neoplasia are important both for their incidence and for their biologic behaviour. They tend to be more aggressive with frequent relapses, metastases and inultiple localizations. We report on 26 CLL patients affected by squamous and basal cell carcinomas observed in our Institute from 1991 to 1996. Fifteen patients were affected by basal cell carcinomas (BCC); 11 by squamous cell carcinomas
We report on a 43-year-old male patient who presented with nodular purple lesions arisen three months before on his right mandibular region. The cutaneous picture was associated with enlargement of lymph nodes in his right submaxillary and latero-cervical regions. There was also hepatosplenomegaly. Blood routinaty tests showed pancytopeny and altered serum enzymatic levels. The patient resulted to be HIV+. Skin biopsy showed the presence of angiosarcomatous tissue. A wide surgical excision of cutaneous lesions with submaxillar and laterocervical lymphadenectomy was performed showing the extention of the tumor to deep tissue and lymph nodes: 11114 metastatic lymph nodes. One month after surgery the patient presented with a relapse on his right temporal region. Three months later the patient died for the progression of both the angiosarcoma and the immunedepressive disorder (AIDS). We report on this case because of its diagnostic difficulty. Differential diagnoses included Kaposi’s sarcoma, particularly frequent in HIV patients, and malignant angiosarcoma or emangioendothelioma of the head, frequent among elderly subjects. The two tumors share some clinical, histological and evolutive aspects but are generally considered different nosologic entities. We feel that in our patient’s lesions must be regarded as angiosarcoma for their localisation, histologic picture and aggressive behaviour. FC24-4
Angiosarcoma
of the scalp:
Case report
M. Robalo Cordeiro, E. Russ, C. Martins, 0. yellechea, J.D. Freitas, A. Figueiredo. Dermatological Department, Coimbra
University
Hospital,
Portugal
Angiosarcoma of face and scalp of elderly is a rare malignant vascular tumor and a clinically distinct entity described by Wilson Jones in 1964. The authors report a typical case of face and scalp angiosarcoma in a 83 year-old woman, who was hospitalized on February 97 with an 7 x 5 cm / angiomatosis lesion on the scalp and forehead, with bleeding erosions and numerous small blue-black nodules at the periphery. Physical examination was normal, except for bilateral cervical lymphadenopathys. Histopathological studies of the lesion and ganglions allow us to identify angiosarcoma. Laboratory findings, chest and skull x-rays, abdominal and cervical ultrasounds and -brain MRI showed no abnormalities. Wide surgical excision. was performed; nevertheless, the clinical course was complicated by bleeding, anemia, inEltration into the underlying. bones, cachexia and death 12 months after diagnosis. The optimum treatment of scalp angiosarcoma remains a problem; early
healed, 71% after WI, 42% after R3, 23% after B3 and 20% after cryo. We found no significant difference between W3 and W 1 (p = 0.84), however, significantly more warts were completely healed after W3 than after R3, B3 and cryo (p c 0.01). respectively. Significantly more warts were healed with WI (p -Z 0.01) and R3 (p c 0.03) than by cryo (p = 0.78) and between R3 and B3 (p = 0.14). We conclude: ALA-PDT is a promising therapy for warts.
FC24. FC24-1
Skin cancer 1 Embryonal rhabdomyosarcoma multiple skin metastases
Serbia, Yugoslavia; of Cardi Wales
t Institute
with the
for
Pathology,
We present a case of embryonal rhabdomyosarcoma with multiple skin metastases in a 2 month old female infant. Soon after birth the rapid painless enlargement of the right eye occurred. Several weeks later skin lesions developed. Physical examination revealed violaceous, firm dermal and subcutaneous nodules on the lower trunk, buttocks, and thighs. Skin biopsy disclosed ill-defined, dense aggregates of poorly differentiated round tumor cells. Tumor cells were positive for desmin, vimentin and muscle specific actin. CT scan demonstrated retrobulbar orbital mass with the extension to the right maxillary sinus and the base of the skull altogether with multiple visceral metastases. The patient succumbed despite chemotherapy started about a week after the diagnosis. Rhabdomyosarcoma is the most common soft tissue tumor of the pediatric population. Cutaneous metastases are extremely rare and present a bad prognostic sign. Multiple dermal or subcutaneous nodules may sometimes present as “blueberry muffin”-like syndrome. Other small round cell tumors to be considered in the differential diagnosis are neuroblastoma, hematolymphoid infiltrates, Ewing sarcoma, primitive neuroectodermal tumor and malignat melanoma FC24-2
Basal and squamous cell carcinomas in patients affected by chronic lymphocytic leukaemia (CLL)
U. Bottoni, F.R. Mauro’, A. Latini, P. Bonaccorsi, D. Innocenzi, E Mandelli’, S. Calvieri. Department of Dermatology; ‘Department of Haematology, University Rome
“La Sapienza”,
Rome,
Skin cancer
s171
1
(XC). These tumours wtre multiple in 4 cases. BCC and SCC are found in 2.6% of patients with CLL and account for 26.5% of all secondary turnours. They are more frequent in patients under antitumoral therapy: 20 out of 26 patients. The aggressive behaviour of skin epithelial cancer in patients with CLL can be explained by both the antiproliferative therapy and the immunosuppression induced by the haematological disorder. of the head in HIV+ patient I FC24 3 Angiosarcoma U. Bottoni, D. Innocenzi, G. Pranteda, P. Bonaccorsi, A. Latini, A. Richetta, V, Silipo, S. Calvieri. Department of Dermatology, University of Rome “La Sapienza”, Rome, Italy
A. Krunic, G. Vujanic’, V. Petronic-Rosic, D. Grkinic, D. Djeric, S. Vesic, M. Gajic. Institute for Dermatology, Belgrade, University
FC24.
of
Italy
In patients with chronic lymphocytic leukaemia (CLL) the risk of developing a secondary neoplasia is considered to be 8 times higher than in general population. Among secondary tumours epithelial neoplasia are important both for their incidence and for their biologic behaviour. They tend to be more aggressive with frequent relapses, metastases and inultiple localizations. We report on 26 CLL patients affected by squamous and basal cell carcinomas observed in our Institute from 1991 to 1996. Fifteen patients were affected by basal cell carcinomas (BCC); 11 by squamous cell carcinomas
We report on a 43-year-old male patient who presented with nodular purple lesions arisen three months before on his right mandibular region. The cutaneous picture was associated with enlargement of lymph nodes in his right submaxillary and latero-cervical regions. There was also hepatosplenomegaly. Blood routinaty tests showed pancytopeny and altered serum enzymatic levels. The patient resulted to be HIV+. Skin biopsy showed the presence of angiosarcomatous tissue. A wide surgical excision of cutaneous lesions with submaxillar and laterocervical lymphadenectomy was performed showing the extention of the tumor to deep tissue and lymph nodes: 11114 metastatic lymph nodes. One month after surgery the patient presented with a relapse on his right temporal region. Three months later the patient died for the progression of both the angiosarcoma and the immunedepressive disorder (AIDS). We report on this case because of its diagnostic difficulty. Differential diagnoses included Kaposi’s sarcoma, particularly frequent in HIV patients, and malignant angiosarcoma or emangioendothelioma of the head, frequent among elderly subjects. The two tumors share some clinical, histological and evolutive aspects but are generally considered different nosologic entities. We feel that in our patient’s lesions must be regarded as angiosarcoma for their localisation, histologic picture and aggressive behaviour. FC24-4
Angiosarcoma
of the scalp:
Case report
M. Robalo Cordeiro, E. Russ, C. Martins, 0. yellechea, J.D. Freitas, A. Figueiredo. Dermatological Department, Coimbra
University
Hospital,
Portugal
Angiosarcoma of face and scalp of elderly is a rare malignant vascular tumor and a clinically distinct entity described by Wilson Jones in 1964. The authors report a typical case of face and scalp angiosarcoma in a 83 year-old woman, who was hospitalized on February 97 with an 7 x 5 cm / angiomatosis lesion on the scalp and forehead, with bleeding erosions and numerous small blue-black nodules at the periphery. Physical examination was normal, except for bilateral cervical lymphadenopathys. Histopathological studies of the lesion and ganglions allow us to identify angiosarcoma. Laboratory findings, chest and skull x-rays, abdominal and cervical ultrasounds and -brain MRI showed no abnormalities. Wide surgical excision. was performed; nevertheless, the clinical course was complicated by bleeding, anemia, inEltration into the underlying. bones, cachexia and death 12 months after diagnosis. The optimum treatment of scalp angiosarcoma remains a problem; early