Keratoacanthoma of the inferior lip: review and report of case with spontaneous regression

Lower lip recurrent keratoacanthoma: A case report

BACKGROUND

This paper introduces a case of recurrent keratoacanthoma (KA). KA is a self-healing disease. Recurrence after surgical resection is rare. In this case, the local application of retinoic acid ointment after the second operation achieved a good prognosis after 2 years of follow-up.

CASE SUMMARY

A 76-year-old male patient was admitted to the hospital for "lower lip rupture and scab for 3 mo". Treatment: A rectangular incision was made in the healthy tissue about 3 mm outside the periphery of the lower lip mass, and a modified Bernard sliding flap was designed to completely remove the mass. Pathology showed (lower lip) KA. When the patient returned 6 mo after surgery, the middle mucosa of the lower lip had a bulge with a diameter of about 0.5 cm. The boundary was still clear, the surface was ulcerated. A recurrence of lower lip KA was suspected and a fan-shaped incision was performed in the healthy tissue about 5 mm outside the lesion to completely resect. Pathological showed lower lip KA had recurred. Topical application of tretinoin cream was applied once a day for 3 mo. The lower lip wounds were clean at the 2-year postoperative follow-up and the mucosa was normal.

CONCLUSION

Adjuvant retinoic acid treatment after KA surgical resection can achieve good results.

Benign and Malignant Lesions of Jaw

Benign and malignant neoplasm of oral cavity is usually presented as swellings or ulcerations of affected tissue. The lesions are broadly categorized as potentially malignant disorders, benign and malignant neoplasm of epithelial and connective tissue origin for the convenience of learning. Neoplasm of oral cavity has a significantly lower incidence. Because of uncommon occurrence of oral neoplasm, retention of diagnostic skills is a challenging task. However, comprehensive understanding on clinical and pathologic details will help in correlating and presenting complaint and assisting in formulation of possible diagnosis. The key for successful therapeutic management depends on achieving right and timely diagnosis.

Keratoacanthoma of the lip: A case report with emphasis on histogenesis

Keratoacanthoma (KA) is a benign epithelial tumor which presents clinically as a proliferating dome-shaped keratin-filled crater. The lesion occurs predominantly upon sun-exposed areas of the body and is known to arise from hair follicle. Actinic rays are a major contributing factor in the etiology. It simulates grossly as well as microscopically a low-grade squamous cell carcinoma. KAs occur habitually on the mucous membrane as well, but their origin in these cases is debatable, owing to the lack of hair follicles in these sites. Our report is an attempt to demonstrate the cells that could be responsible for initiation of this lesion on the oral mucosa.

A clinical, histopathological and immunohistochemical approach to the bewildering diagnosis of keratoacanthoma

Keratoacanthoma (KA) is a comparatively common low-grade tumor that initiates in the pilo-sebaceous glands and pathologically mimics squamous cell carcinoma (SCC). Essentially, strong debates confirm classifying keratoacanthoma as a variant of invasive SCC. The clinical behavior of KA is hardly predictable and the differential diagnosis of keratoacanthoma and other conditions with keratoacanthoma-like pseudocarcinomatous epithelial hyperplasia is challenging, both clinically and histopathologically. This article aims to illustrate and explicate some of these complicated issues by presenting two cases of KA and a relevant review of literature. It also targets the clinical, histopathologic, and immuno-histochemical features of these two cases. Both presented lesions of this study had appeared on the vermilion border of the lower lip and no vascular or perineural invasion was observed. The results of the immuno-histochemical survey, particularly in staining with marker CD30, confirmed the differential diagnosis of keratoacanthoma from keratoacanthoma-like pseudocarcinomatous proliferations which was consequent to the CD30(+) lymphoid infiltration. Histopathological and immunohistochemical investigation is necessary to disprove the invasive biologic behavior of keratoacanthoma and also to refute all conditions with keratoacanthoma-like pseudocarcinomatous epithelial hyperplasia.

Oral potentially malignant disorders: an overview of more than 20 entities

Cancer of the oral cavity accounts for approximately 3% of all malignancies diagnosed annually in 270,000 patients world-wide. Oral cancer is the 12th most common cancer in women and the 6th in men. Many oral squamous cell carcinomas develop from potentially malignant disorders (PMDs). Lack of awareness about the signs and symptoms of oralPMDs in the general population and even healthcare providers is believed to be responsible for the diagnostic delay of these entities. The aim of this article is to update and improve the knowledge of healthcare providers about oral PMDs.

Double localization of keratoacantho-ma on the cutaneous and mucosal sides of the lower lip: report of a case

The clinical course and histological features of keratoacanthoma (KA) are well recognized by dermatologists and pathologists, but they are less familiar to dental professionals. The aims of this report were to describe an unusual case of simultaneous intraoral and labial KA and to identify the most important aspects of the clinical management of this lesion.

A solitary crateriform ulcer of the lower lip: a case report with review of literature

Keratoacanthoma (KA) is a relatively common skin lesion. We report a case of KA-mimicking squamous cell carcinoma in a 40-year old smoker, who was also having speckeled leukoplakia on the buccal mucosa. The present case highlights the importance of histopathological diagnosis, as the treatment in latter case is aggressive, which is unnecessary if attempted with KA. Moreover, the present report provides an overview of such lesions, which could be encountered in clinical situations for which definitive diagnosis is of paramount importance before the starting of treatment plan.

Primary cutaneous anaplastic large cell lymphoma

Anaplastic large cell lymphoma (ALCL) is characterized by proliferation of anaplastic large CD 30+ T-cell lymphoid cells with abundant cytoplasm. Primary cutaneous ALCL is a rare form of ALCL, usually seen in elderly patients. In this report, the authors present an unusual case of 15-year-old boy with a solitary left ear lobe mass, previously reported as keratoacanthoma which was later histopathologically and immunohistochemically diagnosed as T-cell phenotype, anaplastic lymphoma kinase (ALK)-negative primary cutaneous anaplastic large cell lymphoma. The patient's response to chemotherapy was good and he is receiving the continuation phases of his chemotherapy.