Pilonidal sinus associated with cellular blue nevus. A previously unrecognized association
José Fernando Val-Bernal1, María Carmen González-Vela, Sandra Hermana
1Department of Anatomical Pathology, Marqués de Valdecilla University Hospital, Medical Faculty, University of Cantabria, Santander, Spain. apavbj@humv.es
Journal of Cutaneous Pathology
|November 16, 2007
Summary
A rare case of cellular blue nevus (CBN) associated with pilonidal sinus (PS) infection was reported in a young man. Early detection and complete resection are crucial for managing this uncommon condition.
Area of Science:
- Dermatology
- Pathology
- Surgical Oncology
Background:
- Pilonidal sinus (PS) disease is common, but associated neoplasms are rare.
- Cellular blue nevus (CBN) is a melanocytic lesion with a potential diagnostic error rate.
- The co-occurrence of PS and CBN has not been previously documented.
Observation:
- A 19-year-old male presented with recurrent sacrococcygeal PS infection.
- An indurated, blue-black nodule (1.7 cm) was noted, with uncertain clinical diagnosis.
- The nodule was suspected to be a pigmentary or vascular tumor.
Findings:
- Complete surgical resection of both the PS and the nodule was performed.
- Pathological examination revealed a cellular blue nevus (CBN) with an alveolar pattern.
- The CBN demonstrated strong melan-A and HMB-45 reactivity, with focal S-100 positivity and negative Ki-67.
- Differential diagnoses included atypical CBN, borderline melanocytic tumor, and malignant melanoma.
Implications:
- This case highlights the rare association between pilonidal sinus and cellular blue nevus.
- Prompt pathological evaluation is essential for accurate diagnosis of such lesions.
- Radical excision offers a favorable prognosis for this rare combined condition.
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