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Araghi F, Dadkhahfar S, Tabary M, Rakhshan A, Gheisari M. Progressive Primary Plate-Like Osteoma Cutis of the Scalp. Skin Appendage Disord 2021; 7:216-219. [PMID: 34055911 PMCID: PMC8138260 DOI: 10.1159/000512785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 11/04/2020] [Indexed: 11/19/2022] Open
Abstract
Osteoma cutis (OC) or cutaneous ossification refers to uncommon bone formation in the skin. Primary OC develops without any predisposing factor or pre-existing lesion, whereas secondary OC sets out as a dystrophic ossification following traumatic, cicatricial, and neoplastic factors or other cutaneous inflammations. Herein, we report a rare case of long-standing progressive primary OC of the scalp resected in 3 sessions with no recurrence after 1 year.
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Affiliation(s)
- Farnaz Araghi
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sahar Dadkhahfar
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Tabary
- Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Azadeh Rakhshan
- Department of Pathology, Shohada-e-Tajrish Educational Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Gheisari
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Dermatology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Basal Cell Carcinoma of the Eyelid With Metaplastic Bone Formation. Ophthalmic Plast Reconstr Surg 2019; 36:e44-e46. [PMID: 31809487 DOI: 10.1097/iop.0000000000001554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Basal cell carcinoma accounts for 90% of malignant tumors of the eyelid. Basal cell carcinoma has been reported to rarely occur in conjunction with osteoma cutis or bone formation in the skin. The mechanism of this secondary osteoma cutis has yet to be explained. Herein, the authors present the case of a 68-year-old woman with a rapidly enlarging basal cell carcinoma with secondary osteoma cutis of the left lower eyelid.
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Abstract
Osteoma cutis is the formation of bone within the skin. It can present as either primary osteoma cutis or secondary osteoma cutis. Secondary osteoma cutis is more common and is associated with inflammatory, infectious, and neoplastic disorders, including basal cell carcinoma. A 79-year-old Caucasian man without underlying kidney disease or calcium abnormalities presented with a basal cell carcinoma with osteoma cutis on the chin. Basal cell carcinoma with osteoma cutis has seldom been described; however, the occurrence of this phenomenon may be more common than suggested by the currently published literature. The preferred treatment is surgical excision-with or without using Mohs micrographic technique. When the histopathologic examination reveals bone formation in the skin, clinicians should consider the possible presence of an adjacent malignancy, such as a basal cell carcinoma.
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Affiliation(s)
- Stella X Chen
- School of Medicine, University of California, San Diego
| | - Philip R Cohen
- Dermatologist, San Diego Family Dermatology, San Diego, USA
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Harms PW, Fullen DR, Patel RM, Chang D, Shalin SC, Ma L, Wood B, Beer TW, Siddiqui J, Carskadon S, Wang M, Palanisamy N, Fisher GJ, Andea A. Cutaneous basal cell carcinosarcomas: evidence of clonality and recurrent chromosomal losses. Hum Pathol 2015; 46:690-7. [PMID: 25704628 DOI: 10.1016/j.humpath.2015.01.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 01/03/2015] [Indexed: 10/24/2022]
Abstract
Cutaneous carcinosarcomas are heterogeneous group of tumors composed of malignant epithelial and mesenchymal components. Although mutation analyses have identified clonal changes between these morphologically disparate components in some subtypes of cutaneous carcinosarcoma, few cases have been analyzed thus far. To our knowledge, copy number variations (CNVs) and copy-neutral loss of heterozygosity (CN-LOH) have not been investigated in cutaneous carcinosarcomas. We analyzed 4 carcinosarcomas with basal cell carcinoma and osteosarcomatous components for CNVs/CN-LOH by comparative genomic hybridization/single-nucleotide polymorphism array, TP53 hot spot mutations by polymerase chain reaction and Sanger sequencing, and TP53 genomic rearrangements by fluorescence in situ hybridization. All tumors displayed multiple CNV/CN-LOH events (median, 7.5 per tumor). Three of 4 tumors displayed similar CNV/CN-LOH patterns between the epithelial and mesenchymal components within each tumor, supporting a common clonal origin. Recurrent changes included allelic loss at 9p21 (CDKN2A), 9q (PTCH1), and 17p (TP53). Allelic losses of chromosome 16 including CDH1 (E-cadherin) were present in 2 tumors and were restricted to the sarcomatous component. TP53 mutation analysis revealed an R248L mutation in both epithelial and mesenchymal components of 1 tumor. No TP53 rearrangements were identified. Our findings indicate that basal cell carcinosarcomas harbor CNV/CN-LOH changes similar to conventional basal cell carcinoma, with additional changes including recurrent 9p21 losses and a relatively high burden of copy number changes. In addition, most cutaneous carcinosarcomas show evidence of clonality between epithelial and mesenchymal components.
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Affiliation(s)
- Paul W Harms
- Department of Pathology, University of Michigan Health System, Ann Arbor MI 48109; Department of Dermatology, University of Michigan Health System, Ann Arbor MI 48109; Michigan Center for Translational Pathology, University of Michigan Health System, Ann Arbor MI 48109.
| | - Douglas R Fullen
- Department of Pathology, University of Michigan Health System, Ann Arbor MI 48109; Department of Dermatology, University of Michigan Health System, Ann Arbor MI 48109
| | - Rajiv M Patel
- Department of Pathology, University of Michigan Health System, Ann Arbor MI 48109; Department of Dermatology, University of Michigan Health System, Ann Arbor MI 48109
| | - Dannie Chang
- Department of Dermatology, University of Michigan Health System, Ann Arbor MI 48109
| | - Sara C Shalin
- Departments of Pathology and Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR 72205
| | - Linglei Ma
- Miraca Life Sciences, Glen Burnie, MD 21061
| | - Benjamin Wood
- School of Pathology and Laboratory Medicine, University of Western Australia, Perth, WA 6009, Australia
| | - Trevor W Beer
- CliniPath Pathology, Osborne Park, WA 6017, Australia
| | - Javed Siddiqui
- Department of Pathology, University of Michigan Health System, Ann Arbor MI 48109; Michigan Center for Translational Pathology, University of Michigan Health System, Ann Arbor MI 48109
| | | | - Min Wang
- Department of Pathology, University of Michigan Health System, Ann Arbor MI 48109
| | - Nallasivam Palanisamy
- Department of Pathology, University of Michigan Health System, Ann Arbor MI 48109; Michigan Center for Translational Pathology, University of Michigan Health System, Ann Arbor MI 48109; Department of Urology, Henry Ford Health System, Detroit, MI 48202; King Saud University, Riyadh, Saudi Arabia 11362
| | - Gary J Fisher
- Department of Dermatology, University of Michigan Health System, Ann Arbor MI 48109
| | - Aleodor Andea
- Department of Pathology, University of Michigan Health System, Ann Arbor MI 48109; Department of Dermatology, University of Michigan Health System, Ann Arbor MI 48109
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Lee SS, Baker BL, Gapp JD, Rosenberg AE, Googe PB. Ossifying plexiform tumor. J Cutan Pathol 2014; 42:61-5. [DOI: 10.1111/cup.12449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Revised: 03/30/2014] [Accepted: 04/11/2014] [Indexed: 12/01/2022]
Affiliation(s)
- Solomon S. Lee
- Department of Pathology; University of Tennessee Graduate School of Medicine; Knoxville TN USA
| | | | | | | | - Paul B. Googe
- Department of Pathology; University of Tennessee Graduate School of Medicine; Knoxville TN USA
- Knoxville Dermatopathology Laboratory; Knoxville TN USA
- Department of Pathology; Vanderbilt University; Nashville TN USA
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Abstract
: The cutaneous deposition disorders are a group of unrelated conditions characterized by the accumulation of either endogenous or exogenous substances within the skin. These cutaneous deposits are substances that are not normal constituents of the skin and are laid down usually in the dermis, but also in the subcutis, in a variety of different circumstances. There are 5 broad categories of cutaneous deposits. The first group includes calcium salts, bone, and cartilage. The second category includes the hyaline deposits that may be seen in the dermis in several metabolic disorders, such as amyloidosis, gout, porphyria, and lipoid proteinosis. The third category includes various pigments, heavy metals, and complex drug pigments. The fourth category, cutaneous implants, includes substances that are inserted into the skin for cosmetic purposes. The fifth category includes miscellaneous substances, such as oxalate crystals and fiberglass. In this article, the authors review the clinicopathologic characteristics of cutaneous deposition diseases, classify the different types of cutaneous deposits, and identify all the histopathologic features that may assist in diagnosing the origin of a cutaneous deposit.
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Affiliation(s)
- Takenobu Ohashi
- Department of Dermatology Fukushima Medical University Fukushima Japan E-mail: of Plastic Surgery Fukushima Medical University Fukushima, Japan
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Jeannette T, Olga L, Irene P. Cbfa1/Runx2 expression in an ossifying basal cell carcinoma of the eyelid. Arch Dermatol Res 2010; 302:695-700. [DOI: 10.1007/s00403-010-1067-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2009] [Revised: 06/17/2010] [Accepted: 06/22/2010] [Indexed: 10/19/2022]
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Liu K, Tripp S, Layfield LJ. Heterotopic ossification: Review of histologic findings and tissue distribution in a 10-year experience. Pathol Res Pract 2007; 203:633-40. [PMID: 17728073 DOI: 10.1016/j.prp.2007.05.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2006] [Revised: 02/09/2007] [Accepted: 05/24/2007] [Indexed: 10/22/2022]
Abstract
Heterotopic ossification (HO) within tissues involved by a pathologic process is a well-recognized phenomenon. It is most frequently observed in atherosclerotic plaques, in soft tissue around joints, and in the central nervous system. Less frequently, carcinomas and some benign neoplasms will undergo heterotopic ossification. We performed a retrospective review of our experience with HO over a 10-year period to determine the frequency and tissue site distribution of heterotopic ossification. A computerized review of surgical pathology records of approximately 126,000 reports revealed 85 cases in which heterotopic ossification, ectopic bone or metaplastic bone was specifically mentioned in the surgical pathology diagnosis. Twenty-two cases were neoplasms of non-osseous tissues, and 63 cases were non-neoplastic lesions. Immunohistochemical staining for bone morphogenic proteins (BMP) 1, 4, and 6 was performed. Fourteen cases showed staining for BMP-1, 22 cases showed staining for BMP-4, and five cases showed weak staining for BMP-6. HO is a relatively infrequent finding and is more commonly seen in degenerative and reparative conditions than in neoplasms.
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Affiliation(s)
- Katharine Liu
- Department of Pathology, University Hospital, Augusta, GA, USA
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Mc Menamin ME, Goh SGN, Poblet E, Gostelow BE, Robson A, Calonje E. Sarcomatoid Basal Cell Carcinoma—Predilection for Osteosarcomatous Differentiation. Am J Surg Pathol 2006; 30:1299-308. [PMID: 17001162 DOI: 10.1097/01.pas.0000208900.23483.ba] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Primary cutaneous carcinomas rarely show heterologous malignant mesenchymal differentiation. We report 11 cases of sarcomatoid basal cell carcinoma (BCC) with osteosarcomatous differentiation. The patients (7 men and 4 women) ranged in age from 61 to 92 years (median 75 y). The tumors presented as exophytic nodules (0.3 to 7 cm) on the head (n=6), upper limb (n=3), and lower limb (n=2). All lesions were completely excised. Seven patients were alive without evidence of disease (follow-up interval 5 to 24 mo) and 1 patient died of unrelated causes at 7 months without evidence of disease. On histology, the tumors were dermal in location with 2 cases showing focal subcutaneous involvement. Ten tumors were well-circumscribed and 1 tumor showed focally infiltrative edges. Ten tumors revealed conventional BCC associated with varying proportions of osteosarcomatous and undifferentiated sarcomatous stroma. Transition from neoplastic epithelial to mesenchymal cells was seen in 8 cases. One case showed a purely osteoclastic giant cell rich malignant mesenchyme, interpreted as representing early stages of osteosarcomatous transformation. Previously unreported in sarcomatoid BCC, the mesenchymal component of another two cases displayed predominant malignant giant cell tumor like areas and 1 further case disclosed areas reminiscent of telangiectatic osteosarcoma. Pancytokeratins (AE1/3 and MNF116) and smooth muscle actin stained occasional undifferentiated sarcomatous cells in 2 and 3 tumors, respectively. MNF116 and EMA were focally positive in osteosarcomatous tumor cells of 1 case. Although the follow-up interval is short, our data suggest an excellent prognosis for polypoid and exophytic sarcomatoid BCC after complete surgical resection.
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Affiliation(s)
- M E Mc Menamin
- Department of Histopathology, St James's Hospital, Dublin, Ireland
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Salamanca J, Rodriguez-Peralto JL, Gonzalez-Lois C, Azorin D. Ossifying Adult Xanthogranuloma. Arch Pathol Lab Med 2003; 127:e409-10. [PMID: 14521441 DOI: 10.5858/2003-127-e409-oax] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Although a xanthogranuloma is a relatively common benign cutaneous condition and ossification has been observed within many cutaneous lesions, the association between ossification and xanthogranuloma has not, to our knowledge, been reported previously. We believe we describe for the first time the case of a xanthogranuloma with marked osseous metaplasia on the trunk of a 41-year-old woman. Microscopically, the lesion showed typical features of a xanthogranuloma, with the exceptional feature of exuberant bone formation. The presence of bone within this lesion is likely secondary to a metaplastic process.
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Affiliation(s)
- Javier Salamanca
- Pathology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
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Conlin PA, Jimenez-Quintero LP, Rapini RP. Osteomas of the skin revisited: a clinicopathologic review of 74 cases. Am J Dermatopathol 2002; 24:479-83. [PMID: 12454599 DOI: 10.1097/00000372-200212000-00004] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Cutaneous ossification is an unusual event that may be primary or secondary to either inflammatory or neoplastic processes. It is classified as primary when it occurs in the absence of a demonstrable preexisting lesion. Secondary lesions have been most commonly reported occurring with pilomatricoma, basal cell carcinoma, acne vulgaris, and melanocytic nevi (nevus of Nanta). Histologically, the osteomas are composed of well-formed bony spicules with prominent cement lines and calcification. They may demonstrate osteoblasts, osteoclasts, and osteocytes and occasionally may even demonstrate bone marrow elements. We searched the files of a reference dermatopathology laboratory to identify cases of either primary or secondary cutaneous ossification. We present a series of 74 cases of primary and secondary cutaneous ossification. Most cases were secondary in nature. Lesions were more common on the head and neck and in whites. Lesions were also more commonly identified in female patients. In addition, included in our series are 19 cases of nevus of Nanta. To our knowledge, this represents the largest series of such cases in the English literature. Cutaneous ossification is seen both in primary and, more commonly, in secondary conditions involving the skin. Benign neoplasms, especially melanocytic nevi, represent the most common cause of secondary osteoma formation. Women are more commonly affected than men, but the reason for this is unclear. The exact reason why osteoma formation occurs is unclear and requires further study.
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Davis MDP, Pittelkow MR, Lindor NM, Lundstrom CE, Fitzpatrick LA. Progressive extensive osteoma cutis associated with dysmorphic features: a new syndrome? Case report and review of the literature. Br J Dermatol 2002; 146:1075-80. [PMID: 12072082 DOI: 10.1046/j.1365-2133.2002.04674.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Osteoma cutis, also called cutaneous ossification, refers to the rare occurrence of bone in the skin. It may be primary, occurring in normal skin, or secondary, occurring in disrupted skin tissue. A 42-year-old white woman presented with long-standing progressive primary osteoma cutis involving her head and neck, trunk and extremities. She had craniofacial dysmorphism with mid-face hypoplasia, including saddle nose deformity, mild to moderate generalized joint hypermobility, extensive paravertebral ossification, and disc space calcification. The differential diagnosis for this entity is presented. This phenotype may be a previously undescribed syndrome.
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Affiliation(s)
- M D P Davis
- Department of Dermatology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
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