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Pollard WL, Grenier LS, Kobayashi TT. Novel Presentation of Fibroepithelioma of Pinkus on the Ear of a Patient Treated on a Panamanian Humanitarian Mission. Mil Med 2018; 183:e751-e753. [PMID: 29425357 DOI: 10.1093/milmed/usx225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 12/23/2017] [Indexed: 11/14/2022] Open
Abstract
Fibroepithelioma of Pinkus (FEP) is traditionally classified as an unusual variant of basal cell carcinoma. It has non-specific clinical findings yet distinct histologic features. The diagnosis can be challenging for clinicians because it often mimics benign entities such as intradermal nevi. FEP typically occurs on the trunk, but many body sites can be involved including the head, neck, and genitalia. According to a PubMed search of articles indexed in MEDLINE using "Fibroepithelioma of Pinkus" and "ear" or "auricle," there are no reports of FEP specifically occurring on the ear. We describe the first case of FEP on the ear of a heavily sun-damaged male treated while on a military humanitarian mission to Panama. This case helps support the classification of FEP as a basal cell carcinoma variant and raises awareness for this entity as it may be encountered both on military humanitarian missions and in military clinics.
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Affiliation(s)
- Whitney L Pollard
- Department of Dermatology, San Antonio Uniformed Services Health Education Consortium, 1100 Wilford Hall Loop Bldg 4554, JBSA, Lackland, TX
| | - Liesl S Grenier
- Department of Dermatology, Carl R. Darnall Army Medical Center, 36065 Santa Fe Ave, Fort Hood, TX
| | - Todd T Kobayashi
- Department of Dermatology, San Antonio Uniformed Services Health Education Consortium, 1100 Wilford Hall Loop Bldg 4554, JBSA, Lackland, TX
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Flordelis JO, Wu YH, Chen HC. Fibroepithelioma of Pinkus in a 6-year-old boy: a case report. Int J Dermatol 2018; 58:1085-1087. [PMID: 30264493 DOI: 10.1111/ijd.14257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 07/16/2018] [Accepted: 09/09/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Johanna O Flordelis
- Department of Dermatology, Research Institute for Tropical Medicine, Metro Manila, Philippines.,Department of Dermatology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Yu-Hung Wu
- Department of Dermatology, Mackay Memorial Hospital, Taipei, Taiwan.,Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
| | - Hsiu-Chin Chen
- Department of Dermatology, Mackay Memorial Hospital, Taipei, Taiwan
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Mihai MM, Voicu C, Lupu M, Koleva N, Patterson JW, Lotti T, Lotti J, França K, Batashki A, Bakardzhiev I, Wollina U, Tchernev G. Fibroepithelioma of Pinkus (FeP) Located in the Left Lower Quadrant of the Abdomen - Case Report and Review of the Literature. Open Access Maced J Med Sci 2017; 5:439-444. [PMID: 28785327 PMCID: PMC5535652 DOI: 10.3889/oamjms.2017.079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 04/22/2017] [Accepted: 04/23/2017] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Fibroepithelioma of Pinkus (FeP) is an uncommon and controversial skin lesion, sharing features of both basal cell carcinoma (BCC) and trichoepithelioma. In this article, we present a case of FeP and synthesise current concepts on the etiopathogenesis, diagnosis and treatment of this uncommon tumour. CASE REPORT We report the case of an 88-year-old male patient presenting to the dermatology clinic for a sharply demarcated, pink, exophytic cutaneous tumour situated in the left inguinal region. The histopathological examination performed after complete surgical excision of the lesion revealed a diagnosis of FeP. A systematic review of the literature was conducted. The terms `fibroepithelioma` and `Pinkus` have been searched in bibliographical databases, including PubMed and Google Scholar, without time limitation up to February 15th, 2017. Seventy-nine articles that fulfilled all the required conditions were identified. Relevant citations and additional articles identified from references have been assessed. The systematic review included a total number of 452 cases of FeP. CONCLUSION Even though FeP is considered a relatively rare tumour, its true incidence rate might be higher than previously believed. The clinical aspects of the lesion described in this paper and its location in the left lower quadrant of the abdomen are classic features of FeP. Histopathologic examination revealed features of both BCC and trichoepithelioma. Further epidemiological studies are required to clarify whether patients with FEP should be screened for the occurrence of other malignancies.
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Affiliation(s)
- Mara Madalina Mihai
- Oncologic Dermatology and Allergology Department, "Carol Davila" University of Medicine and Pharmacy; 17 Marasti Blvd, Bucharest, Romania
| | - Cristiana Voicu
- Dermatology Department, Polisano Clinic, 26Z Timisoara Blvd, Bucharest, Romania
| | - Mihai Lupu
- Dermatology Department, Medas Medical Centre,41 Nicolae Grigorescu Blvd, Bucharest, Romania
| | - Nely Koleva
- Medical Institute of Ministry of Interior (MVR), Department of Dermatology and Dermatologic Surgery, General Skobelev 79, 1606 Sofia, Bulgaria
| | - James W Patterson
- University of Virginia Health System, 1215 Lee Street, Box 800214, Charlottesville, VA 22908, USA
| | - Torello Lotti
- University of Rome "G. Marconi", Rome, Italy; Department of Biotechnology, Delft University of Technology, 2628 BC, Delft, The Netherlands
| | - Jacopo Lotti
- Department of Nuclear, Subnuclear and Radiation Physics, University of Rome "G. Marconi", Rome, Italy
| | - Katlein França
- Institute for Bioethics & Health Policy; Department of Dermatology & Cutaneous Surgery; Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine - Miami, FL, USA
| | - Atanas Batashki
- Specialist in Abdominal and Thoracic Surgery, Department of special Surgery, Medical University of Plovdiv, bul. "Peshtersko shose" Nr 66, 4000, Plovdiv, Bulgaria
| | - Ilko Bakardzhiev
- Medical College, Medical University of Varna, Varna 9000, Bulgaria
| | - Uwe Wollina
- Department of Dermatology and Allergology, Academic Friedrichstrasse 41, 01067, Dresden, Germany
| | - Georgi Tchernev
- Medical Institute of Ministry of Interior (MVR), Department of Dermatology and Dermatologic Surgery, General Skobelev 79, 1606 Sofia, Bulgaria; Onkoderma - Policlinic for Dermatology, Venereology and Dermatologic Surgery, 26 General Skobelev blvd., Sofia, Bulgaria
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Histopathologic pitfalls of Mohs micrographic surgery and a review of tumor histology. Wien Med Wochenschr 2016; 168:218-227. [PMID: 27832425 DOI: 10.1007/s10354-016-0528-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 10/18/2016] [Indexed: 01/15/2023]
Abstract
Mohs micrographic surgery is a specialized subset of staged surgical excisions with each subsequent stage being driven largely by the histologic findings of the previous stage. Therefore, it is imperative that histologic analysis is performed in an accurate manner. Frozen section and tissue flattening is a crucial step in Mohs surgery. Frozen sections introduce certain artifacts and these artifacts must be interpreted in the correct context. Basal and squamous cell carcinomas are the most common tumors encountered in Mohs micrographic surgery, and their histopathology is also associated with certain "pitfalls". Basal cell carcinoma should be distinguished from hair follicles, folliculocentric basaloid proliferations, poromas, nevus sebaceous, desmoplastic trichoepitheliomas, and spiradenomas, to name but a few histologic entities. Similarly, squamous cell carcinoma should be distinguished from hypertrophic actinic keratoses, pseudoepitheliomatous hyperplasia, sebaceous carcinoma, and microcystic adnexal carcinoma. In addition, there are numerous subtypes of basal cell and squamous carcinomas that the Mohs surgeon should be aware of due to differences in the biologic behavior of these tumors. This review presents a number of the common histologic pitfalls of Mohs micrographic surgery and a review of tumor histology.
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Dongre AM, Khopkar US, Kalyanpad YN, Gole PV. Fibroepithelioma of Pinkus in continuity with nodular basal cell carcinoma: A rare presentation. Indian Dermatol Online J 2016; 7:285-7. [PMID: 27559504 PMCID: PMC4976408 DOI: 10.4103/2229-5178.185477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Fibroepithelioma of Pinkus and nodular basal cell carcinoma (BCC) are different morphological variants of BCC. It is very rare to see both the variants together in a single lesion. Here we report a case of a 56-year-old female who presented with a nodule on the trunk, which on biopsy showed features of both nodular BCC and fibroepithelioma of Pinkus.
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Affiliation(s)
- Atul M Dongre
- Department of Skin and VD, Seth GS Medical College, King Edward Memorial (KEM) Hospital, Mumbai, Maharashtra, India
| | - Uday S Khopkar
- Department of Skin and VD, Seth GS Medical College, King Edward Memorial (KEM) Hospital, Mumbai, Maharashtra, India
| | - Yogesh N Kalyanpad
- Department of Skin and VD, Seth GS Medical College, King Edward Memorial (KEM) Hospital, Mumbai, Maharashtra, India
| | - Prachi V Gole
- Department of Skin and VD, Seth GS Medical College, King Edward Memorial (KEM) Hospital, Mumbai, Maharashtra, India
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Abstract
Background Fibroepithelioma of Pinkus (FeP) is considered a variant of basal cell carcinoma (BCC); however, in the past 20 years, some researchers have argued for its classification as a trichoblastoma. Recently, use of a new immunostaining marker and further dermoscopic characterization of FeP have advanced the debate about its proper classification. Purpose A review of the evidence for and against classification of FeP as BCC or trichoblastoma is presented. Methods Using PubMed, the term FeP was searched and relevant citations were assessed. Additional relevant articles were identified from references of key papers. Results FeP shares characteristics of both trichoblastoma and BCC. Conclusion Derived from the same cell type, BCC and trichoblastoma may be best considered as representing opposite ends of a spectrum of differentiation, with FeP deserving an intermediate classification.
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Affiliation(s)
- Ellen S Haddock
- School of Medicine, University of California San Diego, San Diego, CA, USA.
| | - Philip R Cohen
- Department of Dermatology, University of California San Diego, San Diego, CA, USA
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Inskip M, Longo C, Haddad A. Two adjacent individual fibroepithelioma of Pinkus of the umbilicus-one pink, one pigmented-a case report and review of the literature. Dermatol Pract Concept 2016; 6:17-20. [PMID: 27222767 PMCID: PMC4866622 DOI: 10.5826/dpc.0602a04] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 02/03/2016] [Indexed: 11/11/2022] Open
Abstract
We present a unique case of separate and independent adjacent fibroepitheliomas of Pinkus (FeP) arising from the umbilicus in an 83-year-old man. Of further interest, one is pigmented and the other nonpigmented. Clinical, dermatoscopic and histopathological images are provided. A review of the published literature is undertaken to attempt to assess the incidence of pigmented versus nonpigmented FeP. Of 24 published FeP cases, 10 (41.7%) have been pigmented. Thus to date pigmented FeP comprise approaching one-half of all reported cases.
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Affiliation(s)
- Mike Inskip
- Skin Patrol Skin Cancer Clinic, Berwick, Victoria, Australia
| | - Caterina Longo
- Skin Cancer Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Afaf Haddad
- Dorevitch Pathology, Heidelberg, Victoria, Australia
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Reggiani C, Zalaudek I, Piana S, Longo C, Argenziano G, Lallas A, Pellacani G, Moscarella E. Fibroepithelioma of Pinkus: Case Reports and Review of the Literature. Dermatology 2013; 226:207-11. [DOI: 10.1159/000348707] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 02/01/2013] [Indexed: 11/19/2022] Open
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Zamberk-Majlis P, Velázquez-Tarjuelo D, Avilés-Izquierdo J, Lázaro-Ochaita P. Fibroepitelioma de Pinkus. Descripción dermatoscópica de 3 casos. ACTAS DERMO-SIFILIOGRAFICAS 2009. [DOI: 10.1016/s0001-7310(09)72920-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Dermoscopic Characterization of 3 Cases of Fibroepithelioma of Pinkus. ACTAS DERMO-SIFILIOGRAFICAS 2009. [DOI: 10.1016/s1578-2190(09)70562-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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