Dermal granulomatous inflammation to cornified cells. Significance near cutaneous squamous cell carcinoma

Discrimination of benign from malignant is fundamental to accurate histologic diagnosis. This article describes a series of nine patients with cutaneous squamous cell carcinoma who were noted to have in the vicinity of their neoplasm seemingly benign but biologically significant dermal granulomatous inflammation to cornified cells (GRC).

Two patients were reported as having this finding alone on incisional biopsy specimens only to have subsequent biopsy specimens demonstrate bona fide malignant neoplasms. On Mohs' frozen sections, four patients were noted to have GRC without concomitant tumor and four patients had GRC admixed with tumor. Two patients who demonstrated GRC but no neoplasm on final Mohs' sections had development of recurrent neoplasm after the initial procedure.

In the setting of suspected or proved cutaneous squamous cell carcinoma, GRC signifies the presence of viable neoplasm and warrants additional tissue resection.