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Case Report

Colonisation of Basal Cell Carcinoma and Actinic Keratosis by Malignant Melanoma In Situ in a Patient with Xeroderma Pigmentosum Variant

Department of Pathology, Aberdeen Royal Infirmary, Aberdeen
*
Author to whom correspondence should be addressed.
Clin. Pract. 2012, 2(2), e47; https://doi.org/10.4081/cp.2012.e47
Submission received: 23 October 2011 / Revised: 23 March 2012 / Accepted: 2 April 2012 / Published: 16 April 2012

Abstract

Although malignant melanoma (MM) and both basal cell carcinoma (BCC) and actinic keratosis (AK) are sun-induced lesions, the coexistence of these entities at the same anatomical site (collision tumour) is exceedingly rare. We report the case of a 54-year-old woman with a known history of xeroderma pigmentosum variant (XPV) who presented with 2 separate skin lesions over the middle and upper right forearm, respectively. The clinical impression was that of BCCs or squamous cell lesions. On histological examination, both specimens showed features of melanoma in situ (MIS). In the first lesion, MIS merged with and colonised a superficial and focally invasive BCC. In the second lesion, MIS merged with an AK. No separate invasive nests of malignant melanoma were seen in either specimen. The atypical melanocytes were highlighted by Melan-A and HMB-45 immunostaining, whereas the epithelial cells in both the BCC and AK stained with the pancytokeratin MNF-116. The patient had a previous history of multiple MMs and non-melanomatous skin cancers and finally developed widespread metastatic malignant melanoma, which proved fatal. The rare and interesting phenomenon of collision tumours may pose diagnostic difficulties. To our knowledge, this is the first reported simultaneous presentation of cytologically malignant collision tumours in a patient with XPV.
Keywords: BCC; actinic keratosis; melanoma; xeroderma pigmentosum variant BCC; actinic keratosis; melanoma; xeroderma pigmentosum variant

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MDPI and ACS Style

Smith, L.J.; Husain, E.A. Colonisation of Basal Cell Carcinoma and Actinic Keratosis by Malignant Melanoma In Situ in a Patient with Xeroderma Pigmentosum Variant. Clin. Pract. 2012, 2, e47. https://doi.org/10.4081/cp.2012.e47

AMA Style

Smith LJ, Husain EA. Colonisation of Basal Cell Carcinoma and Actinic Keratosis by Malignant Melanoma In Situ in a Patient with Xeroderma Pigmentosum Variant. Clinics and Practice. 2012; 2(2):e47. https://doi.org/10.4081/cp.2012.e47

Chicago/Turabian Style

Smith, Louise J., and Ehab A. Husain. 2012. "Colonisation of Basal Cell Carcinoma and Actinic Keratosis by Malignant Melanoma In Situ in a Patient with Xeroderma Pigmentosum Variant" Clinics and Practice 2, no. 2: e47. https://doi.org/10.4081/cp.2012.e47

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