Premium
Keratoacanthoma with perineural invasion: An indicator for aggressive behavior?
Author(s) -
Basoglu Yasmin,
Metze Dieter,
Nashan Dorothee,
Ständer Sonja
Publication year - 2008
Publication title -
jddg: journal der deutschen dermatologischen gesellschaft
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 60
eISSN - 1610-0387
pISSN - 1610-0379
DOI - 10.1111/j.1610-0387.2008.06739.x
Subject(s) - keratoacanthoma , perineural invasion , medicine , immunohistochemistry , head and neck , pathology , perineurium , radiation therapy , dermatology , surgery , basal cell , anatomy , cancer , peripheral nerve
Summary Neurotropic invasion of keratoacanthoma (KA) is rare and can easily be missed histologically. A 36‐year‐old woman developed a KA on the upper lip four weeks after CO 2 laser skin resurfacing; it showed microscopic evidence of perineural invasion. Despite repeated treatment with intralesional methotrexate, the KA recurred after 6 months. She was then treated with ionizing radiation (56 Gy) and has been tumor‐free for more than 3 years. Immunohistochemistry showed decreased expression of desmoglein 1 as it is seen in squamous cell carcinomas. In most cases not much importance is attached to perineural invasion which is frequently seen in KA because of the high rate of spontaneous regression. Our case suggests that perineural invasion may be an indicator for aggressive growth of head‐and‐neck KAs so that histologically‐controlled excision is recommended.