[Tumor form of lymphostatic papillomatosis of the skin]

Abstract

The case of a patient with two plantar papillomatous tumours that had had a relapsing course over 10 years is presented. The tumours were located on the right forefoot and the left great toe. Several operations were performed for different diagnoses, i.e. plantar verrucae, verrucous carcinoma and pyoderma vegetans. Histologically, the papillomas proved to be pseudocarcinomatous hyperplasias with multiple ectatic dermal lymph plexuses. Indirect lymphography revealed a circumscribed lymphatic dysplasia with cystic-ectatic cutaneous vessels within the tumour area. Draining lymphatic collectors were conspicuously reduced in number. Isotope lymphography showed a normal lymph transport rate from the foot to the groin. It is concluded that the circumscribed disturbance of lymphatic drainage is the decisive cause of the reactive papillomatous hyperplasia. Thus, these papillomas clinically resembling verrucous carcinoma represent the tumour variant of a papillomatosis cutis lymphostatica.