An Unusual Case of Pinna Squamous Cell Carcinoma Arising Shortly after Resection of Atypical Fibroxanthoma

Abstract

Objective To report a unique case of pinna squamous cell carcinoma (SCC) arising shortly after resection of atypical fibroxanthoma (AFX) at the same site. Case report An 81-year-old gentleman presented with a nodular right pinna lesion. This was excised, and histology confirmed AFX. Ten weeks later, an ulcerative lesion appeared at the resection site. This was confirmed to be SCC. Comparative analysis revealed no morphological resemblance between the initial AFX and new SCC lesion, and there was no evidence of initial misdiagnosis. Conclusion SCC is the most common cancer involving the pinna. Whilst prolonged sun exposure is an important risk factor for SCC, chronic inflammation and wounds are other potential sources. We postulate whether SCC could have arisen from the previous scar tissue in a manner similar to Marjolin's ulcer. This would be a highly unusual finding in the pinna and to our knowledge unprecedented in the English literature.

Collision Tumor Comprised of Atypical Fibroxanthoma and Invasive Squamous Cell Carcinoma: A Case Report of an Extremely Rare Entity

“…AFX usually occurs on sun-exposed areas and presents as a small pink-red, firm, asymptomatic solitary nodule. Most cases of AFX are locally aggressive and carry a good prognosis but in rare cases, reoccurrence and metastasis can occur [2]. We present a distinctive case of moderately differentiated squamous cell carcinoma (SCC) and AFX occurring as a collision tumor of the right shoulder.…”