A few cases of pigmented squamous cell carcinoma affecting the skin and the
ocular and oral mucosa of the elderly have been described in the literature. The
disease manifests itself as papular and nodular erythematous or pigmented
lesions. The main clinical differential diagnoses are pigmented basal cell
carcinoma and melanoma. Histopathological examination is characterized by
proliferation of atypical squamous cells with formation of horn pearls permeated
by dendritic melanocytes. For this reason, a careful diagnosis is necessary to
rule out other tumors that show melanin pigment. Surgical removal is the
indicated treatment and the prognosis is similar to the classical squamous cell
carcinoma. We report a case of pigmented squamous cell carcinoma with diagnosis
confirmed by histological and immunohistochemical examinations.
Cutaneous metastases are uncommon in daily practice, although very important,
since they may be the first manifestation of an undiscovered primary neoplasm or
the first indication of recurrence. Cutaneous metastases from the breast are the
most frequent in women and cutaneous metastases from the lung are the most
frequent in men. Thyroid carcinoma, despite representing the most frequent
endocrine neoplasm, is considered a rare neoplasm, corresponding to 1% of
malignant neoplasms diagnosed. Cutaneous metastases from follicular carcinoma
are rare and occur mainly in the head and neck area. We report a case of
cutaneous metastasis in a patient with follicular thyroid carcinoma and breast
carcinoma. Because of the association of these two neoplasms, the possibility of
Cowden Syndrome - multiple hamartoma syndrome - was raised, but was excluded by
genetic analysis of PTEN gene.
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