Squamous Cell Carcinoma Developing in Jadassohn's Sebaceous Nevus

Abstract

The authors have indicated no significant interest with commercial supporters. N evus sebaceous (or Jadassohn's sebaceous nevus or organoid nevus) is a well-known congenital skin hamartoma involving ectodermand mesoderm-derived structures that usually appears in the head and face area. During childhood, the lesion remains static but, during puberty, grows and becomes more evident and verrucous. These changes reveal growth of pilosebaceous and apocrine elements, probably because of the influence of androgens. 1,2Depending on location and size, nevus sebaceous causes only aesthetic problems, although in adulthood, benign and malignant neoplasms develop in approximately 15% of cases. 2 Of malignant tumors, the most common is basal cell carcinoma (BCC), which has an estimated incidence in nevus sebaceous of less than 2%. Other malignant tumors are rare. 3 To our knowledge, only 12 squamous cell carcinomas (SCCs) and eight adnexal have been described. [4][5][6][7][8][9][10][11][12][13][14] We are reporting an unusual case of SCC that appeared on a Jadassohn's sebaceous nevus in a 41-year-old man. Its clinical and evolutive features are compared with those of previously published cases. Case ReportIn December 2002, a 41-year-old man sought medical advice for a 3-month history of a growing nodule on a congenital lesion of his face. Clinical examination revealed, on the inferior portion of his left cheek, a pink-yellowish verrucous plaque, 2 Â 0.8 cm in size, with a centrally ulcerated and crusted erythematous nodule, 1 Â 0.8 cm in size, arising on the external end of the plaque (Figure 1). Enlarged regional lymph nodes were not detected. The patient had no history of cutaneous cancer, immunosuppression, or local trauma.The lesion was completely excised with wide margins. Histopathologic examination showed the presence of a large number of mature sebaceous glands and papillomatous hyperplasia of the epidermis (Figure 2). A SCC developed within the nevus sebaceous. The squamous carcinoma cells invaded the upper dermis without desmoplasia. There was a moderate infiltrate of lymphocytes between the carcinomatous cells (Figures 3 and 4). The lesion also showed mature apocrine glands located in the lower dermis.The patient remains well, without clinical evidence of recurrence, after more than 8 years of follow-up. DiscussionJadassohn's sebaceous nevus is an hamartomatous skin malformation present in 0.3% of newborns. 15

Dermoscopic Analysis of Nevus Sebaceus of Jadassohn: A Study of 13 Cases

“…Benign tumors [12,27,28,29,30,31,32] are the most common neoplasms, including syringocystadenoma papilliferum, apocrine cystadenoma, trichoblastoma, trichilemmal cysts, and keratoacanthoma. Although less common, malignant degeneration [33,34,35,36,37,38,39,40,41,42,43,44,45,46,47] occurs, with a lifetime risk of 5-20%. The majority of these tumors are basal cell carcinomas, but squamous cell, sebaceous, and apocrine carcinomas have also been recognized [2,13].…”

Acantholytic Squamous Cell Carcinoma Arising in a Nevus Sebaceous : A Case Report

“…Tumors observed together included BCC with SCC, sebaceous carcinoma, or KA and SCC with adnexal carcinoma. (3,8,9,10) Our case is very rare variant of SCC (acantholytic) that has not been reported to date arising in nevus sebaceous.…”

“…(6) Other types of benign neoplasms are trichilemmoma, sebaceoma, seborrheic keratosis, syringoma, poroma, nodular hidradenoma, apocrine cystadenoma, and nonepithelial proliferations such as melanocytic nevi. (7) The true incidence of malignant tumors occurring in lesions of NS is difficult to determine. In a review study done by Megan N, the most common malignancy observed was BCC.…”

A Rare Entity of Giant Epidermal Exophytic Naevus of Hemifacial Region

“…Rodins K and Baillie L have reported a rare case of hybrid follicular cyst with matrical differentiation consisting of basaloid matrical-type cells with luminal shadow cell keratinization [12]. The malignant transformation potential of sebaceous nevi has been found to be less than 1% [13].…”

“…He suggested that these nevi are caused by effect of a few functionally abnormal clones. He categorized nevi in to two patterns, anatomical in which abnormal clone of cells are limited to the pathologic skin and functional, in which the two are spatially unrelated and hence may not follow Blaschko lines [12,13].…”