We present a rare case of KRAS keratinocytic epidermal nevus syndrome with lymphatic malformation, responsive to treatment with sirolimus, an mTOR inhibitor. A brief review of the current literature regarding sirolimus use in vascular malformations, lymphatic malformations, regional overgrowth syndromes, and RASopathies is discussed.
Cutaneous collision tumours are the co-existence of two tumours of different histopathological morphologies that coincide at the same or adjacent anatomical sites. A large scalp nodule excised from a 70 year-old man revealed a collision tumour composed of cells of squamous carcinoma (SCC) and malignant melanoma. Immunohistochemistry using dual staining for melanoma and squamous cell carcinoma demonstrated an unusual pattern; nests of melanoma cells surrounded by a layer of squamous carcinoma cells. The unique architecture observed in the case suggested a relationship between the two tumours.
Conflicts of interest: P.J.M. is employed by GP Synergy, the Australian Regional Training Organisation that provides specialist general practitioner vocational training for New South Wales and the Australian Capital Territory.
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