Primary Invasive Squamous Cell Carcinoma of the Nipple

Squamous Cell Carcinoma Arising within Verruca Vulgaris on the Nipple

Cutaneous squamous cell carcinoma (SCC) is a common form of skin cancer and often appears as a hard, scaly lump that occasionally ulcerates. It is usually associated with cumulative exposure to ultraviolet light, although prior scarring, chronic wounds, exposure to radiation, HPV infection, and immunosuppression are also associated risk factors. Primary SCC of the nipple is very rare and only a few cases have been reported. We present a case of a 49-year-old female with concerns of a right nipple lesion with erythema and pain. She was initially evaluated for Paget's disease with an underlying malignancy and cellulitis, but, after biopsy and investigation, she was found to have a well-differentiated SCC arising from a verruca vulgaris. Current literature does not provide distinct guidelines on management of SCC or its variants on the nipple, and the case was managed based off of SCC at other cutaneous sites as well as other cases of SCC on the nipple.

Advancing RF pulse design using an open-competition format: Report from the 2015 ISMRM challenge

PURPOSE

To advance the best solutions to two important RF pulse design problems with an open head-to-head competition.

METHODS

Two sub-challenges were formulated in which contestants competed to design the shortest simultaneous multislice (SMS) refocusing pulses and slice-selective parallel transmission (pTx) excitation pulses, subject to realistic hardware and safety constraints. Short refocusing pulses are needed for spin echo SMS imaging at high multiband factors, and short slice-selective pTx pulses are needed for multislice imaging in ultra-high field MRI. Each sub-challenge comprised two phases, in which the first phase posed problems with a low barrier of entry, and the second phase encouraged solutions that performed well in general. The Challenge ran from October 2015 to May 2016.

RESULTS

The pTx Challenge winners developed a spokes pulse design method that combined variable-rate selective excitation with an efficient method to enforce SAR constraints, which achieved 10.6 times shorter pulse durations than conventional approaches. The SMS Challenge winners developed a time-optimal control multiband pulse design algorithm that achieved 5.1 times shorter pulse durations than conventional approaches.

CONCLUSION

The Challenge led to rapid step improvements in solutions to significant problems in RF excitation for SMS imaging and ultra-high field MRI. Magn Reson Med 78:1352-1361, 2017. © 2016 International Society for Magnetic Resonance in Medicine.

A common cancer in an uncommon location: A case report of squamous cell carcinoma of the nipple

•

Squamous cell cancer of the nipple is rare but should be included in the differential diagnoses of pathologies of the nipple.

•

Patients with former history of skin cancer may present with skin cancers in unusual locations.

•

Thorough clinical and diagnostic evaluations are mandatory to rule out pathologiesand direct management decisions.

Introduction

Cutaneous squamous cell carcinoma (SCC) is common however SCC is rarely seen on the nipple, with only ten cases of SCC of the nipple in literature (American Cancer Society, 2015; Scotto et al., 1983; Pendse and O’Connor, 2015; Loveland-Jones et al., 2010; Brookes et al., 2005; Sofos et al., 2013; King and Kremer, 2012; Venkataseshan et al., 1994; Hosaka et al., 2011) [1–9].

Case

An 80 year old female presenting with a chief complaint of an abnormal lesion on the medial portion of her right nipple areola complex. A biopsy showed well-differentiated squamous cell carcinoma. She had an extensive history of prolonged sun exposure predisposing her to cutaneous SCC however none to the breast region. Her mammogram was negative for any invasive disease so a wide local excision was performed with no complications.

Discussion

Due to the rarity of SCC of the breast or nipple, a biopsy is necessary to rule out other more common types of malignancies on the nipple that present with a similar physical appearance. We then examined the many different risk factors for SCC and the different methods for treating SCC whether it is cutaneous or of the nipple or breast. We also discussed the treatment of Paget’s disease of the breast (PDB) as SCC of the nipple or breast can be mistaken for PDB.

Conclusion

The cases of SCC of the Nipple demonstrate the importance of recognizing changes of the skin even in locations not typically associated with SCC (American Cancer Society, 2015; Scotto et al., 1983; Pendse and O’Connor, 2015; Loveland-Jones et al., 2010; Brookes et al., 2005; Sofos et al., 2013; King and Kremer, 2012; Venkataseshan et al., 1994; Hosaka et al., 2011) [1–9]. We concluded with a future suggestion of investigating possible risk factors specific to SCC of the breast or nipple.