Zusammenfassung
Wir berichten über einen Fall mit kombinierten Komponenten eines Plattenepithelkarzinoms und malignen Melanoms in einem soliden Tumor des Augenlides von einem 74-jährigen Mann. Unseres Wissens ist dies der erste Fallbericht einer solchen Kombination eines Lidtumors. Der histologische Befund zeigte einen soliden anterioren Lidkantentumor mit Infiltration der Lidhaut und der benachbarten Konjunktiva sowie des Musculus orbicularis. Der hyper- und parakeratotische hornperlenreiche epitheliale Tumoranteil mit positiver Zytokeratin-AE1 /AE3-Anfärbung zeigte eine geringgradige Zellatypie und eine deutliche Invasion in die Tiefe. Zwischen den epithelialen Tumorinseln waren Ansammlungen von leicht pigmentierten melanozytischen Tumorzellen zu finden. Diese waren immunohistochemisch mit HMB45 und Melan-A positiv anfärbbar und wiesen ebenfalls ein invasives Wachstum in die Tiefe sowie eine intraepitheliale Infiltration auf.
Abstract
We present a case report of co-existent components of squamous cell carcinoma and malignant melanoma within a solid eyelid tumour in a 74-year-old male. The particular composite of these two malignancies in ocular adnexa is to the best of our knowledge reported for the first time. The histological findings exhibited a solid anterior lid tumour infiltrating the skin and surrounding conjunctiva, as well as the orbicular muscles. The hyper- and parakeratotic keratin-rich squamous cell carcinoma was cytokeratin AE1 / AE3 positive, had a slight atypia but an obvious invasion in the depth. Between the squamous cell carcinoma cells were islands of HMB45 and Melan-A positive melanoma cells with slight pigmentation, which demonstrated not only subcutaneous but also intraepithelial invasion.
Schlüsselwörter
Lider - Okuläre Tumoren - Pathologie
Key words
lids - pathology - ocular tumours
Literatur
-
1
Akiyama M, Inamoto N, Nakamura K.
Malignant melanoma and squamous cell carcinoma forming one tumour on a burn scar.
Dermatology.
1997;
194 (2)
157-61
-
2
Breslow A.
Thickness, cross-sectional areas and depth of invasion in the prognosis of cutaneous melanoma.
Ann Surg.
1970;
172 (5)
902-908
-
3
Cook B E, Bartley G B.
Epidemiologic characteristics and clinical course of patients with malignant eyelid tumors in an incidence cohort in Olmsted County, Minnesota.
Ophthalmology.
1999;
106 (4)
746-750
-
4
El-Hayek Jr M, Lestringant G G, Frossard P M.
Xeroderma pigmentosum in four siblings with three different types of malignancies simultaneously in one.
J Pediatr Hematol Oncol.
2004;
26 (8)
473-475
-
5
Esmaeli B, Wang B, Deavers M. et al .
Prognostic factors for survival in malignant melanoma of the eyelid skin.
Ophthal Plast Reconstr Surg.
2000;
16 (4)
250-257
-
6
Jurado I, Saez A, Luelmo J. et al .
Pigmented squamous cell carcinoma of the skin: report of two cases and review of the literature.
Am J Dermatopathol.
1998;
20 (6)
578-581
-
7
Kamino H, Tam S T, Alvarez L.
Malignant melanoma with pseudocarcinomatous hyperplasia – an entity that can simulate squamous cell carcinoma. A light-microscopic and immunohistochemical study of four cases.
Am J Dermatopathol.
1990;
12 (5)
446-451
-
8
Kraemer K H, Lee M M, Scotto J.
Xeroderma pigmentosum. Cutaneous, ocular, and neurologic abnormalities in 830 published cases.
Arch Dermatol.
1987;
123 (2)
241-250
-
9 Margo C E. Pigmented lesions of the eye lid, in Principles and Practices of Ophthalmlogy. Albert DM, Jakobiec FA and eds Philadelphia; Saunders 2000 2nd: 3430-3446
-
10
Mihm M C, Clark Jr W H, From Jr L.
The clinical diagnosis, classification and histogenetic concepts of the early stages of cutaneous malignant melanomas.
N Engl J Med.
1971;
284 (19)
1078-1082
-
11
Nakahara H, Kitamura R, Shirasuna K.
Simultaneous malignant melanoma and squamous cell carcinoma of the oral cavity: a case report.
J Oral Maxillofac Surg.
1995;
53 (12)
1455-1457
-
12
Pigeaud-Klessens M L, Valk van der P.
Multiple neoplasms: a case report.
Orbit.
2002;
21 (2)
145-148
-
13
Reifler D M, Hornblass A.
Squamous cell carcinoma of the eyelid.
Surv Ophthalmol.
1986;
30 (6)
349-365
-
14
Rosen L B, Williams W D, Benson J. et al .
A malignant neoplasm with features of both squamous cell carcinoma and malignant melanoma.
Am J Dermatopathol.
1984;
6 (Suppl)
213-219
Dr. Jing Hua
Universitätsaugenklinik Freiburg
Killian Straße 5
79106 Freiburg
Phone: ++ 49/7 61/2 70 40 01
Fax: ++ 49/7 61/2 70 40 57
Email: jing.hua@bristol.ac.uk
