Malignant changes in a giant orbital keratoacanthoma developing over 25 years

Authors: Alyahya, G.A.; Heegaard, S.; Prause, J.U.

Source: Acta Ophthalmologica Scandinavica, Volume 78, Number 2, 1 April 2000 , pp. 223-225(3)

Publisher: Wiley-Blackwell

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Abstract:

.Purpose:

To report a patient with a history over 25 years of a slowly growing, large, invasive crateriform tumour filling the anterior part of the orbit.

Methods:

A 61-year-old male presented with a large tumour of the left orbit. Exenteration was performed with subsequent histological analysis of the excised mass.

Results:

The main tumour showed the characteristic features of a keratoacanthoma. However, the posterior aspect of the tumour disclosed the morphology of a squamous cell carcinoma. Six months later, the patient presented with metastases to lymph nodes, lung and mediastinal tissue. A leukemoid reaction was diagnosed by fine needle biopsy.

Conclusion:

The giant variety of keratoacanthoma may fail to regress and can transform into a squamous cell carcinoma. In our patient, the development of a chronic lymphoid leukemia raises the possibility that it may be the underlying cause for the transformation of the posterior part of the keratoacanthoma into a frank squamous cell carcinoma.

Keywords: keratoacanthoma; squamous cell carcinoma; tumour; benign; malignant; histopathology; immunohistochemistry; orbit

Document Type: Case report

Affiliations: 1: Eye Pathology Institute, University of Copenhagen, Denmark

Publication date: 2000-04-01