Rare Secondary Neoplasms Arising in Epidermal Nevus: A Case Series and Literature Review.
Haya A Homsi, Melissa Piliang, Jennifer Lucas et al.
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Case in brief
This report describes three patients with epidermal nevi (EN) present since birth who developed new lesions within them. A 40-year-old woman had a congenital verrucal plaque from the mons pubis to the left thigh; histology showed EN with syringofibroadenoma, syringocystadenoma papilliferum (SCAP), and basal cell carcinoma. A 31-year-old man developed verrucous pink nodules in congenital EN, with SCAP and trichilemmoma identified microscopically. A 29-year-old woman’s suspicious papule within a knee EN was diagnosed as trichilemmoma after excision. The report recommends regular follow-up, while the relationship between the tumors and EN remains uncertain.
What made this case unusual
Several distinct epithelial and adnexal tumors, including basal cell carcinoma, were found arising within congenital EN across the cases; whether these tumors are clonally related to the nevi or coincidental remains unresolved.
Diagnostic / clinical pearl
A new nodule or papule within an EN warrants consideration of a secondary neoplasm and histologic assessment, as illustrated by the varied tumors in this report.