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[Keratoacanthoma: two cases with intravascular spread]
Annabel Gottfarstein-Maruani1, Patrick Michenet, Rémy Kerdraon
1Service d'Anatomie et de Cytologie Pathologiques, CHR d'Orléans, Hôpital de la Source, BP 6709, 45067 Orléans 2.
Annales De Pathologie
|January 31, 2004
Summary
Keratoacanthoma can exhibit aggressive histological features like intravascular spread, which typically suggests malignancy but doesn't exclude this diagnosis. These features may indicate a unique form of squamous cell carcinoma.
Area of Science:
- Dermatopathology
- Oncology
Background:
- Keratoacanthoma (KA) is a common skin tumor, often self-limiting.
- Histological evaluation is crucial for differentiating KA from squamous cell carcinoma (SCC).
Observation:
- Two patients with keratoacanthoma presented with typical histological features.
- Unusual histological findings included intravascular spread in both patients and perineural invasion in one.
- Intravascular spread, typically a sign of malignancy, was observed despite a non-malignant clinical course.
Findings:
- The presence of intravascular spread and perineural invasion did not preclude a diagnosis of keratoacanthoma.
- These aggressive histological features are not consistently associated with a malignant clinical outcome in the literature.
- Intravascular spread suggests keratoacanthoma might represent a variant of well-differentiated squamous cell carcinoma.
Implications:
- Careful comparison of clinical and pathological findings is essential for accurate keratoacanthoma diagnosis.
- Understanding these aggressive histological features aids in differentiating keratoacanthoma from invasive squamous cell carcinoma.
- This study highlights the potential overlap between keratoacanthoma and well-differentiated squamous cell carcinoma, necessitating refined diagnostic criteria.