Epidermal inclusion cysts are an exceedingly common entity seldom seen in association with a malignant tumor. Herein, we report a unique case of an epithelial inclusion cyst seen in association with an atypical lipomatous tumor/well-differentiated liposarcoma. The epidermal inclusion cyst was delimited to the dermis and circumferentially enveloped by an atypical adipocyte tumor containing myxoid foci and comprised of lipoblasts. This case underscores the importance of scrutinizing the entirety of cysts and other ostensibly trivial dermal entities to avoid the pitfall of misdiagnosing a potentially serious tumor.
Background: Basal cell carcinoma (BCC) is the most common cutaneous neoplasm. It is most often a locally invasive tumour and rarely affects the vulva. Distant spread of BCC is rarer still and there are few cases reported of metastatic vulval primary tumours. Basosquamous carcinoma is regarded as a high-risk variant of BCC and its behaviour is unpredictable. Though more aggressive, it tends to grow locally rather than spread to lymph nodes as seen in squamous cell carcinoma (SCC). Case: We present a case of a basosquamous BCC arising in the vulva with involvement of the external and common iliac lymph nodes. Conclusion: Metastatic BCC has a poor prognosis and there are no definitive guidelines for its investigation or management. We recommend staging with imaging and potentially lymph node dissection in patients with large lesions involving underlying structures or aggressive histology.
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