Dorsal giant skin horn: a clinical-histological study
Abstract: Introduction: The term cutaneous horn refers to a cone-shaped structure consisting of keratin, which, unlike animal horns, lacks a bony core. They appear more frequently on the face, ears, and the back of the hands, in elderly people with keratin-producing injuries. These ca...
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| Formato: | Artículo revista |
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2021
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/35061 |
| Aporte de: |
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I10-R327-article-35061 |
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Universidad Nacional de Córdoba |
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I-10 |
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R-327 |
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Revista de la Facultad de Ciencias Médicas de Córdoba |
| format |
Artículo revista |
| topic |
skin neoplasms verrucous carcinoma keratosis cutaneous horn neoplasias cutáneas carcinoma verrucoso queratosis cuerno cutáneo . |
| spellingShingle |
skin neoplasms verrucous carcinoma keratosis cutaneous horn neoplasias cutáneas carcinoma verrucoso queratosis cuerno cutáneo . Ferro , A Alcain , WL Szlabi, S Scarinci , E Pérez , HJ Cremonezzi, DC Dorsal giant skin horn: a clinical-histological study |
| topic_facet |
skin neoplasms verrucous carcinoma keratosis cutaneous horn neoplasias cutáneas carcinoma verrucoso queratosis cuerno cutáneo . |
| author |
Ferro , A Alcain , WL Szlabi, S Scarinci , E Pérez , HJ Cremonezzi, DC |
| author_facet |
Ferro , A Alcain , WL Szlabi, S Scarinci , E Pérez , HJ Cremonezzi, DC |
| author_sort |
Ferro , A |
| title |
Dorsal giant skin horn: a clinical-histological study |
| title_short |
Dorsal giant skin horn: a clinical-histological study |
| title_full |
Dorsal giant skin horn: a clinical-histological study |
| title_fullStr |
Dorsal giant skin horn: a clinical-histological study |
| title_full_unstemmed |
Dorsal giant skin horn: a clinical-histological study |
| title_sort |
dorsal giant skin horn: a clinical-histological study |
| description |
Abstract:
Introduction: The term cutaneous horn refers to a cone-shaped structure consisting of keratin, which, unlike animal horns, lacks a bony core.
They appear more frequently on the face, ears, and the back of the hands, in elderly people with keratin-producing injuries. These can be benign, premalignant or malignant. We present this case because of its infrequent location, its extreme length, and its long evolution. Furthermore, although the clinical features are especially notorious, what is significant in these injuries is that they may be a malignancy macroscopic manifestation.
Case Presentation: An 88-year-old woman arrived with a long-standing injury on her back. Surgery was performed and the cutaneous horn was removed. Macroscopy: We received a cutaneous horn of keratinous appearance measuring 30 cm and a maximum diameter of 5 cm, with a 1-cm-thick skin lozenge measuring 4 cm in diameter. Sections of the skin injury were cut and processed with the common hematoxylin/eosin staining technique.
Histologically, the baseline skin injury was a verrucous carcinoma shaped by solid nests and cords, with the formation of keratin pearls and marked hyperkeratosis. Nuclear grade and mitotic count were low. The surrounding stroma was desmoplastic with mild, diffuse inflammatory infiltrate, and no lymphatic or hematic vascular infiltration was observed. Neoplasm invaded deep into the lower third of the reticular dermis. Surgical margins were free.
Conclusion: This type of injury, no matter how harmless it may seem, must be removed with a wide margin of healthy tissue, since in many instances the underlying process that causes the hyperkeratosis is of neoplastic nature, as in this case. It should only be referred to as a cutaneous horn when the underlying injury is epidermal hyperplasia. On the other hand, we have not found bibliography with a cutaneous horn of these dimensions, resembling an animal horn.
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| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2021 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/35061 |
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I10-R327-article-350612024-04-15T16:19:09Z Dorsal giant skin horn: a clinical-histological study Cuerno cutáneo gigante dorsal: un estudio clínico-histológico A Ferro , A Alcain , WL Szlabi, S Scarinci , E Pérez , HJ Cremonezzi, DC skin neoplasms verrucous carcinoma keratosis cutaneous horn neoplasias cutáneas carcinoma verrucoso queratosis cuerno cutáneo . Abstract: Introduction: The term cutaneous horn refers to a cone-shaped structure consisting of keratin, which, unlike animal horns, lacks a bony core. They appear more frequently on the face, ears, and the back of the hands, in elderly people with keratin-producing injuries. These can be benign, premalignant or malignant. We present this case because of its infrequent location, its extreme length, and its long evolution. Furthermore, although the clinical features are especially notorious, what is significant in these injuries is that they may be a malignancy macroscopic manifestation. Case Presentation: An 88-year-old woman arrived with a long-standing injury on her back. Surgery was performed and the cutaneous horn was removed. Macroscopy: We received a cutaneous horn of keratinous appearance measuring 30 cm and a maximum diameter of 5 cm, with a 1-cm-thick skin lozenge measuring 4 cm in diameter. Sections of the skin injury were cut and processed with the common hematoxylin/eosin staining technique. Histologically, the baseline skin injury was a verrucous carcinoma shaped by solid nests and cords, with the formation of keratin pearls and marked hyperkeratosis. Nuclear grade and mitotic count were low. The surrounding stroma was desmoplastic with mild, diffuse inflammatory infiltrate, and no lymphatic or hematic vascular infiltration was observed. Neoplasm invaded deep into the lower third of the reticular dermis. Surgical margins were free. Conclusion: This type of injury, no matter how harmless it may seem, must be removed with a wide margin of healthy tissue, since in many instances the underlying process that causes the hyperkeratosis is of neoplastic nature, as in this case. It should only be referred to as a cutaneous horn when the underlying injury is epidermal hyperplasia. On the other hand, we have not found bibliography with a cutaneous horn of these dimensions, resembling an animal horn. Resumen: Introducción: el término cuerno cutáneo se refiere a una estructura en forma de cono constituida por queratina, que a diferencia de los cuernos de animales, carece de core óseo. Aparecen con más frecuencia en rostro, orejas y dorso de manos, en ancianos que presentan lesiones con producción de queratina. Estas pueden ser benignas, premalignas o malignas. Presentamos el caso debido a su infrecuente localización, a su extrema longitud y a su larga evolución. Además, si bien lo que llama la atención es la presentación clínica, lo importante en estas lesiones es que pueden ser la expresión macroscópica de un proceso maligno. Presentación del caso: mujer de 88 años que concurre a la consulta por una lesión localizada en el dorso de mucho tiempo de evolución. Se decide intervención quirúrgica y se extraen un cuerno cutáneo. Macroscopia: recibimos un cuerno cutáneo de aspecto queratinoso que mide 30 cm de longitud y 5 cm de diámetro; y un losange de piel de 1 cm de espesor y 4 cm de diámetro. Se realizaron cortes de la lesión de piel y se procesaron con la técnica habitual para coloración con hematoxilina/eosina. Histológicamente la lesión de base en la piel fue un carcinoma verrugoso conformado por nidos sólidos y cordones, con formación de perlas córneas y marcada hiperqueratosis. El grado nuclear y recuento mitótico fueron bajos. El estroma adyacente fue desmoplásico con moderada infiltrado inflamatorio difuso; no se observó permeación vascular linfática o hemática. La neoplasia invadió en profundidad hasta el tercio inferior de la dermis reticular. Los márgenes quirúrgicos estaban libres de lesión. Conclusión: Este tipo de lesiones, por más inofensivas que parezcan, deben resecarse y con buen margen de tejido sano, ya que en numerosas oportunidades el proceso subyacente que origina la hiperqueratosis es de naturaleza neoplásica como en este caso. Sólo debe denominarse cuerno cutáneo cuando la lesión de origen es una hiperplasia epidérmica. Por otra parte, no hemos hallado en la bibliografía un cuerno cutáneo de estas dimensiones muy similar, a cuernos de animales. . Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2021-10-12 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion texto texto texto https://revistas.unc.edu.ar/index.php/med/article/view/35061 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 78 No. Suplemento (2021): Suplemento JIC XXII Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 78 Núm. Suplemento (2021): Suplemento JIC XXII Revista da Faculdade de Ciências Médicas de Córdoba; v. 78 n. Suplemento (2021): Suplemento JIC XXII 1853-0605 0014-6722 http://creativecommons.org/licenses/by-nc/4.0 |