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Fibromatoses generally comprise a broad spectrum of myofibroblastic proliferation of similar histomorphology. Desmoid-type fibromatoses (desmoid tumors) are locally aggressive lesions which principally involve deep soft tissue structures. The author describes a 35-year-old female, who was found to have a nodular subcutaneous resistance arising in the upper portion of the right inguinal region. The tumor measured 40 x 25 x 15 mm and adhered to the aponeurosis of the abdominal internal oblique muscle. Histology revealed a dense mass of proliferating spindle-shaped myofibroblasts of uniform appearance. At the periphery, the lesion was poorly circumscribed and infiltrated an adjacent striated muscle. A diagnosis of desmoid-type fibromatosis was made. Desmoid tumor is a quite rare oncologic entity. Although it never metastasizes, it can lead to significant morbidity due to locally aggressive behaviour with a striking tendency to recur. Every patient once treated for deep fibromatosis requires long-term follow-up. [ABSTRACT FROM AUTHOR]

Desmoplastic Spitz nevus (DSN) is an uncommon variant of melanocytic nevus rarely encountered in dermatological practice. Herein, we describe a 54-year-old male who presented himself with a cutaneous tumor arising from the left arm. Histology revealed an intradermal proliferation of somewhat pleomorphic, epithelioid, spindled melanocytes in a background of desmoplastic stroma. A perineural invasion of tumor cells was found. Proliferative and mitotic rates were minimal. The tumor was diffusely positive for S-100 protein, PNL-2, and SOX-10, and only occasionally reactive for melan-A and HMB-45. The final diagnosis of DSN was established. Although DSN is a completely benign tumor, it may result in diagnostic pitfalls. Due to its unusual histopathological features, it may be confused with a malignant desmoplastic melanoma. A knowledge of the clinicopathological differences between the two prognostically distinct skin tumor entities is essential for a differential diagnosis. [ABSTRACT FROM AUTHOR]

We report a case of an 85-year-old man, who presented with a polypoid skin tumor in the left lumbal region. Histology revealed a malignant tumor composed predominantly of pleomorphic basaloid cell population with a high mitotic and proliferative activity. This cellular component was admixed with aggregates of anuclear cells with eosinophilic cytoplasm reminiscent of „shadow” cells seen in pilomatrixoma, as well as with whorls of keratin material reminiscent of squamoid pearls. Immunohistochemically, the basaloid tumor part was positive for CD10, p120catenin and CD138 and very sporadically positive for cytokeratin 19 and BerEP4. Cytokeratin 20 was negative and epithelial membrane antigen labelled only eosinophilic squamoid structures. In some areas, numerous interspersed dentritic melanocytes strongly immunoreactive for S-100 protein were arranged singly and in larger expansile nests within basaloid tumor mass. Histopathology and immunoprofile of lesion favored a diagnosis of pilomatrical carcinoma with intratumorous melanocytic proliferation. To the best of our knowledge, only a few such cases have been described untill now. [ABSTRACT FROM AUTHOR]

Squamous cell carcinoma (SCC) of the skin includes many histologic subtypes with varying microscopic features and clinical behaviors. Clear cell SCC belongs to one of the rare histologic variants of this cutaneous malignancy. Herein, two cases are described in a 78-year-old man arising on the cheek and in a 79-year-old woman arising on the neck. In both examples, histology revealed an intraepidermal (in situ) SCC with a predominant clear cell change of malignant keratinocytes. In addition, a typical keratinizing squamous cell component was also present. Clear cell population showed apparent mitotic and proliferative activity. In one patient, it slightly stained with periodic acid-Shiff (PAS) method. Staining with alcian blue was negative in both cases. Knowledge on histomorphology and pathogenesis of this tumor entity is discussed. [ABSTRACT FROM AUTHOR]

Basal cell carcinoma with clear cell differentiation is extremely rare variant of this cutaneous malignancy. Here, two new cases are described in a 68-year old man arising on the scapula and in a 76-year old man arising on the face. Histologically, sharply demarcated islands consisting of the large cells with clear and focally foamy cytoplasm were found within a conventional nodular and superficial-nodular basal cell carcinoma. In both cases, clear cell population showed no mitoses, low or absent proliferative activity and was immunohistochemically positive for p53 protein. In one case, it apparently stained with alcian blue, but not with periodic acid-Shiff method, suggesting the accumulation of acid mucopolysacharides. Present results are compared with the literature data and knowledge on histogenesis of this tumor entity is discussed. [ABSTRACT FROM AUTHOR]

Melanoma of the skin usually does not reach a greater dimension. The authors describe unique case of the patient with a huge (giant) primary cutaneous melanoma. 56-year-old man was diagnosed to have melanoma arising on the left foot. Partial surgical amputation with a complete tumor removal was done. Melanoma measured 8 x 4 cm and exhibited massive ulceration, Breslow's thickness 15 mm, Clark's level V, high mitotic and proliferative activity. A patient was classified as stage III B. After surgery, he was relegated to the oncological dispensary health care and took part additional clinical investigations. Finally, PET/CT scan revealed pulmonary and regional lymph node metastases. Therefore, paliative chemotherapy was started. Huge skin melanomas like this are very rarely diagnosed in clinical practice and they are almost always the result of long-term neglect of growing lesion. Currently, it is not answered, whether certain specific factors predispose some melanomas to grow such enormously. [ABSTRACT FROM AUTHOR]

Introduction: E-cadherin is important cell-cell adhesion molecule, that plays a crucial role in the maintenance of tissue microarchitecture. In many human malignancies, reduced or loss of E-cadherin production in neoplastic cells correlates with tumor dedifferentiation and acquisition of the invasive and metastatic potential. In contrast to most other cancers, basal cell carcinoma (BCC) of the skin possess some unique features, such as slow local growth, strong stroma-dependency, and virtual absence of metastases. Aim: In the present study, we immunohistochemically evaluated expression of E-cadherin in a set of cutaneous BCCs. Material and methods: Study group consisted of 41 primary BCCs cathegorized into non-infiltrative subroup (superfical and nodular subtypes) and infiltrative subroup (nodular-infiltrative and infiltrative subtypes). Results: E-cadherin was expressed in all tumor specimens with variable quantitative range and intensity. There were 19 cases (46.3 %) with preserved and 22 cases (53.7 %) with reduced E-cadherin expression. In superficial, nodular, nodular-infiltrative and infiltrative BCC subtypes, reduced E-cadherin immunoreactivity was found in 40 % (2/5), 56.2 % (9/16), 54.5 % (6/11) and 55.5 % (5/9), respectively. We did not confirm a significant correlation between expression of E-cadherin and both given, non-infiltrative and infiltrative BCC subgroup. None of the tumors examined showed apparent decreasing immunostaining intensity in tumor tissue with increasing depth of invasion. There were not convincing differences either between the central and peripheral parts of tumor mass, or in the vertical dimension. Conclusions: Reduction of E-cadherin expression per se does not seem to directly contribute to the acqusition of more aggressive phenotype in cutaneous BCC. This may represent another peculiarity, by which BCC differs from the most other epithelial malignancies and reflect a distinct tumor biology. [ABSTRACT FROM AUTHOR]

Introduction: In malignant melanoma of the skin, age has been found to be one of the factors associated with different clinical outcome and prognosis of disease. The purpose of our study was to investigate differences in the incidence and clinicopathological findings of cutaneous melanoma in relation to the age of the patients. Material and methods: Study group consisted of 116 primary invasive malignant melanomas of the skin from 116 subjects (57 men, 59 women) between 31 - 93 years of age. They were stratified into three separate age groups: group I (⩽ 43 years, young age), group II (44 - 60 years, middle age) and group III (⩾ 61 years, old age). Results: In group I, II and III, we confirmed 22 (19%), 45 (38.8%) and 49 (42.2%) individuals, respectively. As age increased, proportion of males, as well as melanomas located on the head and neck were rising. There was evident decline in the percentage of superficial spreading melanoma and conversely, increase in the percentage of nodular melanoma. Acral lentiginous melanoma and lentigo maligna melanoma was found only in patients over 60 years old. In general, advancing age was associated with lower prevalence of stage pT1 and higher prevalence of stage pT4, higher mean Breslow's thickness and mitotic rate and with larger proportion of ulcerated lesions. In comparision to younger individuals, patients ⩾ 61 years of age exhibited melanocytic nevus remnants in melanomas less commonly. Conclusion: We found apparent age-related differences in the incidence and clinicopathological characteristics of malignant melanoma of the skin. In general, unfavourable prognostic variables predominated in the oldest population. Further research is needed to clarify, to what extent are these age-related disparities associated with distinct etiopathogenetic mechanisms and primary tumor biology. [ABSTRACT FROM AUTHOR]