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While intradermal nevi are common benign pigmented skin tumors, their occurrence within the external auditory canal is uncommon. The clinical and pathologic features of an intradermal nevus arising within the external auditory canal are presented, and the literature reviewed.
We report an exceptional case of metastatic adenocarcinoma of the breast occurring within a benign intradermal nevus. An extensive review of the literature on metastatic breast carcinoma is included.
We report here a 7-year-old Japanese girl with cerebriform intradermal nevus (CIN). By placement of expanders on the galea, her scalp was expanded more easily with less discomfort than is expected when the expanders are placed under the galea. An immunohistochemical study on the expression of proliferating cell nuclear antigen suggested higher proliferative activity of nevus cells from the CIN lesion than that of cells from congenital or acquired intradermal nevi. The high proliferative activity appeared to be associated with a growth spurt of the lesion.
A clinical case resembling cutis verticis gyrata due to a cerebriform intradermal nevus (CIN) is reported. Such a lesion is diagnosed on clinical and histopathological grounds. Some aspects are particularly discussed, such as complications of CIN, including the potential development of malignant melanoma, prognosis and different possibilities in the therapeutic approach. It is stressed that early diagnosis, broad surgical excision and plastic reconstruction are major issues. Different techniques of surgical extirpation and scalpflap reconstruction are presented.
A case of epidermoid cyst associated with an unusual amelanotic intradermal nevus, with structures identical to Meissner's tactile corpuscles, is reported. The possible relationship and the origin of both lesions are discussed.
A case of malignant melanoma apparently arising from the lower portion of a preexisting intradermal hairy nevus is presented. This case is an exception to the general rule that if malignant melanomas arise from nevi they originate in nevi with a junctional component.
A case is reported of an extended cerebriform intradermal naevus of the scalp. Additional skin findings were generalized small intradermal and compound-type naevi. There were no neurological or other internal anomalies.
We report the cases of three patients with lobulated intradermal nevi. Biopsy specimens showed similar findings, that is, fatty infiltration within nests of nevus cells, neuroid differentiation of nevus cells, and dermal fibrosis. Our cases probably represent an unusual form of regressing melanocytic nevus.
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Two cases of a distinctive variant of Spitz (spindle and epithelioid cell) nevus are described. One lesion developed on the lower leg of a 17-year-old boy and the other lesion on the back of a 52-year-old man. The microscopic appearance was characterized by a plexiform arrangement of bundles and lobules of enlarged spindle to epithelioid melanocytes throughout the superficial and deep dermis. Intraepidermal melanocytic proliferation was unappreciated. Some lobules were circumscribed by a thin rim of compressed fibrous tissue. In both cases a myxoid stroma was present. The cells had abundant eosinophilic cytoplasm with well-defined borders. The nuclei were enlarged, consistently ovoid and vesicular, with small nucleoli. Both cases contained scattered multinucleate giant cells similar to those observed in classical form of Spitz nevi. No melanin pigment was detectable by light microscopy. No mitoses were observed in one case and a rare mitosis was present in the other. Tumor cells were strongly immunoreactive for S-100, but not for HMB-45, desmin, and actin. The differential diagnosis of this distinctive tumor includes desmoplastic/neurotropic melanoma, plexiform spindle cell nevus, cellular blue nevus, plexiform neurofibroma, and cellular neurothekeoma. The designation of "plexiform Spitz nevus" is chosen to emphasize its distinctive plexiform growth pattern.
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A silver colloidal technique to demonstrate argyrophilic proteins of the nucleolar organizer regions (AgNORs) was performed on sections of 20 cases of malignant melanoma (MM) associated with underlying benign nevus (BN). In these cases, significant different AgNOR counts were found for MM and BN. In addition, this technique permitted the identification of melanocytic cells located between malignant and benign cells showing AgNOR scores intermediate (5.51) between BN (2.6) and MM (7.71) with a more complex and bizarre morphology than that observed in BN. The AgNOR technique can be suitable in the identification of residual nevus cells in MM, especially when their number is minimal and the common histologic criteria are unsatisfactory; it can also increase the understanding of the natural history of MM.
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