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Malignant changes in a giant orbital keratoacanthoma developing over 25 years
G A Alyahya1, S Heegaard, J U Prause
1Eye Pathology Institute, University of Copenhagen, Denmark.
Acta Ophthalmologica Scandinavica
|May 4, 2000
Summary
A giant keratoacanthoma transformed into squamous cell carcinoma in a patient with chronic lymphoid leukemia. This case highlights potential links between leukemia and tumor progression, emphasizing the need for vigilant monitoring.
Area of Science:
- Ophthalmology
- Dermatology
- Oncology
Background:
- Keratoacanthomas (KAs) are typically benign skin tumors known for rapid growth and spontaneous regression.
- Giant KAs are rare variants that may exhibit aggressive behavior and fail to regress.
Observation:
- A 61-year-old male presented with a large, invasive, crateriform orbital tumor present for over 25 years.
- Histological analysis revealed a mixed tumor with features of keratoacanthoma and squamous cell carcinoma.
Findings:
- The tumor exhibited transformation from keratoacanthoma to squamous cell carcinoma.
- The patient developed metastases to lymph nodes, lung, and mediastinum six months post-exenteration.
- A leukemoid reaction was noted, and chronic lymphoid leukemia was diagnosed.
Implications:
- Giant keratoacanthomas may undergo malignant transformation into squamous cell carcinoma.
- Chronic lymphoid leukemia might be a contributing factor in the malignant progression of keratoacanthoma.
- This case underscores the importance of thorough histological evaluation and long-term follow-up for unusual keratoacanthoma presentations.