Concurrent presentation of porocarcinoma and basal cell carcinoma arising on a capillary malformation: a case report

Abstract

Porocarcinoma (PC) and basal cell carcinoma (BCC) are distinct skin cancers. Few studies have documented the occurrence of two concurrent types of skin cancers, and to the best of our knowledge, this represents the inaugural report of such a coexisting lesion arising from a capillary malformation. Herein, we report a case of concurrent PC and BCC presenting with capillary malformation. A 93-year-old woman visited our hospital with a protruding mass in her right nasal ala that appeared as a capillary malformation. A biopsy was performed on the skin lesion, and BCC was diagnosed. A wide excision was performed. Permanent biopsy revealed that the skin lesion was a PC with basal cells and squamous differentiation. The safety margin of the deep tissue margin was < 0.1 cm; however, considering the advanced age of the patient, further excision was deemed to not possess any benefits. This case illustrates the importance of recognizing the possibility of multiple skin cancers, even in patients with benign lesions such as capillary malformations. The rarity of this presentation highlights the importance of thorough investigation and histopathological examination of skin lesions in guiding appropriate surgical excision.

Keywords: Basal cell carcinoma; Case reports; Eccrine porocarcinoma; Vascular malformations.

Fig. 1.

A 93-year-old woman with a hemangioma on the right hemiface showing a protruding mass on the right nasal ala.

Fig. 2.

Preoperative images showing a 3.4 cm exophytic mass with a depth of 2 mm. (A) Magnetic resonance imaging and (B) computed tomography.

Fig. 3.

Postoperative photographs. (A) Immediately and (B) 1 month after the surgery.

Fig. 4.

Tissue specimen stained with hematoxylin and eosin. (A) The area labeled “S” in the figure represents the superficial part of the tissue specimen, whereas the area labeled “D” represents the deeper part. Normal skin tissue can be observed (red dotted circle), and basal cell carcinoma (BCC) invasion is visible. Porocarcinoma has grown beyond the normal skin. Tissue specimen slide, magnified by ×12. (B) Photograph of area “A,” magnified by ×800, which shows the presence of a porocarcinoma. Misshapen nuclei and irregularly sized cells were observed, and ductal differentiation was visible. Clear fluid can be seen inside the duct, which is a characteristic feature of porocarcinomas originating from eccrine sweat glands. (C) Photograph of area “B,” magnified at ×400, which shows the invasion of normal skin by BCC. BCC forms nests, and the cells stand in a palisade pattern at the edge.