Seborrheic Keratosis With Malignant Transformation (Invasive or Noninvasive Squamous Cell Carcinoma Arising in Seborrheic Keratosis): A Clinicopathologic and Immunohistochemical Study of 11 Cases
Seborrheic Keratosis With Malignant Transformation (Invasive or Noninvasive Squamous Cell Carcinoma Arising in Seborrheic Keratosis): A Clinicopathologic and Immunohistochemical Study of 11 Cases
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脂溢性角化病恶变（脂溢性角化病引起的侵袭性或非侵袭性鳞状细胞癌）：11例临床病理学和免疫组织化学研究
DOI：
10.1097/dad.0000000000002245
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Honma Keiichiro
中科院分区：
文献类型：
--
作者：
Goto Keisuke;Ogawa Kohei;Hishima Tsunekazu;Oishi Naoki;Tomita Ozumi;Tsuyuki Takuji;Oda Takao;Iwahashi Yoshifumi;Inaba Yutaka;Honma Keiichiro
摘要脂溢性角化病是一种常见的由基底细胞组成的良性肿瘤。然而，对肿瘤的恶性转化知之甚少。本文分析了11例脂溢性角化病恶变病例。11例患者包括5例男性患者和6例女性患者，诊断时的中位年龄为75岁（68-90岁）。肿瘤发生在从头皮（n= 3）到小腿（n= 2）的不同部位。7例非侵袭性和4例侵袭性病例的中位肿瘤大小分别为12（10-32）和40（20-75）mm。1例患者表现出在途皮肤转移。恶性成分的组织学类似于汗孔癌或倒滤泡角化病。经常观察到Bowenoid和Pagetoid扩散。癌旁组织表达角蛋白5/6（100%）和GATA 3（73%），而不表达角蛋白7（0%）、角蛋白19（9%）、BerEP 4（0%）、c-kit（0%）和NUT（0%）。在所有病例中均未观察到YAP 1的显著免疫反应性。在91%和82%的病例中，分别观察到p53和PTEN的MUR型免疫染色。7例非浸润性癌中有6例（86%）p16表达增加，4例浸润性癌中有3例（75%）p16表达缺失。这项研究表明，脂溢性角化病可以发生恶性转化，特别是在老年患者的大尺寸病变。恶性成分类似于汗孔癌或倒滤泡角化病。本研究提示TP 53和PTEN突变可导致恶性转化，CDKN 2A失活突变可导致肿瘤侵袭。
Seborrheic keratosis is a common benign neoplasm composed of basaloid keratinocytes. However, little is known about the malignant transformation of the tumor. Eleven cases of seborrheic keratosis with malignant transformation were analyzed. The 11 patients included 5 male patients and 6 female patients with a median age of 75 years at diagnosis (68–90 years). The tumors arose at various sites from the scalp (n= 3) to the lower leg (n= 2). The median tumor size was 12 (10–32) and 40 (20–75) mm in 7 noninvasive and 4 invasive cases, respectively. One patient exhibited in-transit skin metastasis. Histopathology of the malignant components resembled porocarcinoma or inverted follicular keratosis. Bowenoid and pagetoid spreading was frequently observed. The malignant components expressed cytokeratin 5/6 (100%) and GATA3 (73%), but not cytokeratin 7 (0%), cytokeratin 19 (9%), BerEP4 (0%), c-kit (0%), and NUT (0%). No significant immunoreactivity of YAP1 was observed in any of the cases. Mutant-type immunostaining of p53 and PTEN was observed in 91% and 82% of the cases, respectively. An increase in p16 expression was seen in 6 (86%) of the 7 cases with noninvasive carcinoma, although a loss of p16 immunoexpression was seen in the invasive carcinoma component in 3 (75%) of the 4 cases. This study demonstrated that seborrheic keratosis can undergo malignant transformation, particularly in large-sized lesions in elderly patients. Malignant components mimic porocarcinoma or inverted follicular keratosis. Malignant transformation induced by TP53 and PTEN mutations and tumor invasion by CDKN2A inactivating mutations are suggested in this study.
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影响因子：
1.7
作者：
Gupta D;Singh N;Goyal A;Toi PCh;Thappa DM
通讯作者：
Thappa DM
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影响因子：
3.3
作者：
T. Terada
通讯作者：
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DOI：
10.1111/j.1346-8138.1997.tb02798.x
发表时间：
1997
期刊：
Journal of dermatology (Print)
影响因子：
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作者：
T. Akasaka;S. Kon
通讯作者：
S. Kon
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影响因子：
1.7
作者：
Johanna O. Flordelis;Ying;Yu
通讯作者：
Yu
脂溢性角化病引起的基底细胞癌
DOI：
10.1111/j.1365-2230.2009.03323.x
发表时间：
2009
期刊：
Clincal and Experimental Dermatology
影响因子：
--
作者：
M. Laing;C. O'keane;G. Murphy
通讯作者：
G. Murphy