Three cases of multiple basal cell carcinoma arising in port-wine stains previously treated with thorium X

Basal Cell Carcinoma Arising over a Venous Malformation of the Forehead Communicating with the Endocranial Veins

INTRODUCTION

An increasing number of skin cancer arising over vascular anomaly has been reported in literature. In such cases, the oncologic radicality required to threat skin malignancies may be in contrast with the safety needed when dealing with vascular malformation. As a result, treatment of this association may be insidious and treacherous and imposes a sound knowledge and carefulness.

MATERIALS AND METHODS

The authors report on a case of a 77-years-old woman affected by a basal cell carcinoma (BCC) arising over a vascular malformation of forehead. Preoperative radiological imaging revealed an underlying venous malformation (VM) communicating with intracranial district. Patient underwent sclerotherapy of the VM with gelified ethanol in order to reduce potentially fatal bleeding during surgery and, on the other hand, any leakage of the sclerosant in the intracranial veins. Excision of the BCC was then performed without complications.

RESULTS

Neither intra-operative nor post-operative complications were observed. Current 3-years follow-up shows no recurrence of BCC whilst the residual VM is stable and clinically silent.

CONCLUSIONS

Mechanisms leading to the onset of skin cancers over venous malformations are still unclear. However, association between these 2 conditions may be underestimated with possible catastrophic consequences. Thorough knowledge of vascular malformations and a multidisciplinary approach is of the uttermost importance when dealing with such clinical challenges.

Multiple Basal Cell Carcinomas Arising in a Port-Wine Stain with a Remote History of Therapeutic Irradiation

The coexistence of a basal cell carcinoma and a port-wine stain is a very rare condition that may be associated with previous treatments. We present a case of multiple basal cell carcinomas developing within the boundaries of a port-wine stain, which had been treated with a tholium X and argon laser. Our case suggests that port-wine stains which were previously treated with irradiation or argon laser should be examined carefully and regularly by both physician and patient, because they may hide basal cell carcinomas.

Current concepts: laser treatment of adult vascular lesions

Patients frequently seek treatment of cutaneous vascular lesions for both medical and cosmetic reasons. Advances in the use of lasers and light sources enable physicians to effectively treat vascular lesions that were previously untreatable. Given the plethora of devices available, selecting the appropriate laser system and treatment parameters can be confusing for the laser surgeon. This article reviews current concepts in the treatment of adult vascular conditions. It highlights the different types of lasers and the most common vascular lesions amenable to therapy. Also, the article offers several pearls regarding selection of the laser and of the treatment parameters.

Basal cell carcinoma arising over facial port wine stain: a single-centre experience

BACKGROUND

A growing number of reports point to a possible connection between basal cell carcinoma (BCC) and port wine stain (PWS). Researchers suggest that either the elevated temperature induced by the increased dermal vasculature or an oncogenic factor produced by the ectatic vessels makes the overlying epidermis more susceptible to ultraviolet or ionizing radiation.

OBJECTIVE

To check the prevalence of BCC in patients with PWS at a large national vascular amomalies centre.

METHODS

The study group included 68 patients, 44 women and 24 men, with facial PWSs. Detailed data were collected on background features, past treatments and past exposure to radiation, and a comprehensive physical examination was performed. Biopsy samples were taken from suspect lesions for histological study.

RESULTS

Four patients (5.9%) were found to have histologically proven BCC, 3 nodular and one multifocal. All had been exposed to radiation during childhood. Treatment consisted of excision; there was one recurrence.

CONCLUSION

Although the co-occurrence of BCC and PWS is probably related to radiation treatment in childhood, these findings should alert physicians to regularly examine PWSs for cancerous changes, especially in patients at risk.

Basal Cell Carcinoma Arising in a Port-Wine Stain

BACKGROUND

The occurrence of basal cell carcinoma within a port-wine stain or nevus flammeus is rare. Sixteen cases of basal cell carcinoma which developed in a port-wine stain or nevus flammeus have been reported.

OBJECTIVE

The objective was to demonstrate a rare case of basal cell carcinoma occurring in a port-wine stain successfully treated with Mohs micrographic surgery.

METHODS

This is a case report and literature review.

RESULTS

An 87-year-old man presented with a basal cell carcinoma on the margin of a previously untreated port-wine stain on the left cheek. Histologic examination showed a nodular basal cell carcinoma. The basal cell carcinoma was completely excised with Mohs micrographic surgery and complex linear closure was used to repair the wound in layers. The postoperative course was complicated by a hematoma, which developed 24 hr postoperatively. The hematoma was drained and there was no further bleeding or evidence of recurrence of the tumor after 12 months.

CONCLUSION

Basal cell carcinoma should be included in the differential diagnosis of a skin lesion occurring in a port-wine stain.

Multifocal Basal Cell Carcinoma Developing in a Facial Port Wine Stain Treated with Argon and Pulsed Dye Laser: A Possible Role for Previous Radiotherapy

BACKGROUND

Basal cell carcinoma occurring in port wine stain is extremely rare but has been reported after radiotherapy for port wine stain.

OBJECTIVE

The objective was to present 55-year-old man with a facial port wine stain who had multiple treatment sessions with both the argon laser and the pulsed dye laser and subsequently developed a recurrent multifocal basal cell carcinoma and highlight the treatment carried out and its effects on the outcome.

METHODS

We describe the history of the patient's port wine stain treatment, the development of skin cancer within it, and the different modalities of therapy carried out.

RESULTS

The patient developed basal cell carcinoma in his port wine stain. The possibility of a causal link between laser treatment and this skin cancer was considered but it was discovered that he had had radiotherapy treatment of his birthmark at age 9. The basal cell carcinoma was successfully treated.

CONCLUSION

This case of a clinically indistinct multifocal basal cell carcinoma arising within facial port wine stain was most likely due to previous radiotherapy treatment as a child, rather than laser treatment. Careful treatment history should identify such patients who should be followed-up for development of skin cancer.

Basal cell carcinomata in port wine stains

The development of basal cell carcinoma (BCC) in a port wine stain is rare and the aetiology of these malignancies in this situation is the subject of some debate. Early treatment of port wine stains with ionising radiation has been implicated in the development of BCC. The use of the argon laser has not been implicated. We present four cases of BCC in port wine stains, one previously treated with an argon laser, and discuss the possible aetiological factors.

Vascular tumors arising in port-wine stains: two cases of pyogenic granuloma and a case of acquired tufted angioma

Three female patients affected by intradermal vascular tumors were presented. The lesions were acquired and developed from preexisting port-wine stains (PWS). Among the three patients observed, two had a pyogenic granuloma (PG) and the third patients had tufted angiomas. As reported earlier, formation of a PG within the lesion of a PWS supports the assumption that arteriovenous anastomoses are associated with its pathogenesis. Occurrence of tufted angioma from a PWS, as well as coexisting but separate PWS has been reported. However, the tufted angiomas of our patient were located in different sites, one in the PWS and others separate from the PWS. This has never previously been reported.