Malignancies Within Rhinophyma: Report of Three New Cases and Review of the Literature

Abstract

These three new cases and the review of 43 cases reported in the literature call attention to the clinical features of carcinomas arising in the context of rhinophyma, raising further concerns about the possible association between these two entities. The need for histologic examination of all surgically removed tissue in patients with rhinophyma is highlighted. Several macroscopic changes, including ulceration, drainage, and a rapid growth pattern, should alarm the physician and should be considered as suspicious of a malignant degeneration. Unexpected clinical modifications of a preexisting long-lasting silent rhinophyma could indicate the possibility of hidden malignancy rather than a rhinophyma itself. Although evidence of an association between the two entities remains inconclusive, half of the malignancies reported in our review were incidental findings associated with rhinophyma. Thus, since rhinophyma should not be considered solely a cosmetic problem, we recommend that all specimens be reviewed by a pathologist and if malignancy is diagnosed, re-excision with clear margins should be achieved when necessary with periodic follow-up.

Excision of Rhinophyma with Radiofrequency Surgery.

“…Tümörleşme olasılığı da pek yoktur (5) . Zemininde çok az sayıda bazal hücreli karsinoma ve çok nadir olarak da yassı hücreli karsinoma, anjiosarkoma ve lenfositik lenfoma bildirilmiştir (5,6) .…”

Procedural management of rhinophyma: A comprehensive review

“…Although rhinophyma is considered a benign process, various neoplasms have been detected in surgical specimens including basal cell carcinoma (BCC), squamous cell carcinoma (SCC), mixed SCC/BCC, sebaceous gland carcinoma, and angiosarcoma . Cases with hidden malignancies present with sudden enlargement and ulceration and should alert the physician to the presence of an underlying neoplasm rather than attributable to disease progression alone.…”

“…Cases with hidden malignancies present with sudden enlargement and ulceration and should alert the physician to the presence of an underlying neoplasm rather than attributable to disease progression alone. It remains unclear if these carcinomas are simply incidental findings or whether the underlying hyperplasia and scarring drive neoplastic development . Since many treatments destroy rhinophymatous tissue, with no specimen available for histologic analysis, the number of neoplasms is likely under‐reported.…”

Acne Rosacea

“…Although rhinophyma is often accepted as a presentation of last stage of rosacea, it may occur in patients with few or no other features of rosacea. One diagnosis is a clinical one, and biopsy is only indicated to rule out alternative diagnoses or in suspicion of a malignancy such as basal cell carcinoma or squamous cell carcinoma [15].…”