Keratoacanthoma of Upper Lip: Review and Report of Case Managed Surgically

Abstract

Keratoacanthoma is a benign lesion usually presenting as a solitary, dome shaped nodule with a central crater filled with keratin. It frequently occurs on the sun exposed areas of the skin. Keratoacanthoma can be difficult to differentiate from oral squamous cell carcinoma both clinically and microscopically. A case of keratoacanthoma involving the upper lip in a 51-year-old male is reported presenting as an exophytic growth that resolved after excisional biopsy.

Keywords: Crater; Oral squamous cell carcinoma; Stratified squamous epithelium.

[Table/Fig-1a]:

Clinical presentation at the first time of reporting

[Table/Fig-1b]:

Clinical presentation after one week (Note the increase in size)

[Table/Fig-2a]:

Immediate post operative photograph

[Table/Fig-2b]:

Excised specimen after fixation in 10% formalin

[Table/Fig-3a]:

Photomicrograph of H&E section showing a large crateriform lesion with adjacent normal epithelium (40X)

[Table/Fig-3b]:

Photomicrograph of H&E section showing the crater filled with ortho-keratin (100X)

[Table/Fig-3c]:

Photomicrograph of H&E section showing deeper portion of the lesion where it appears infiltrating the underlying connective tissue. Note that the individual cells do not show dysplastic features, keratinocytes shows glassy cytoplasm and the juxta lesional connective tissue is densely infiltrated by chronic inflammatory cells (100X)

[Table/Fig-4a]:

Clinical presentation at a follow up of one month;

[Table/Fig-4b]:

Clinical presentation at a follow up of six months