Background: A rare case of triphasic tumour with elements of sarcoma, melanoma and cutaneous carcinoma on the same scalp lesion.
Methods: An immunocompromised retired seventy year old gentleman attended our department for treatment of a rapidly growing large exophytic mass on his scalp. The patient had a background of Squamous Cell Carcinoma resected in another centre and reconstruction with split thickness skin graft. It rapidly recurred following resection and new biopsies reported the lesion as a Desmoplastic Melanoma. A wider excision and reconstruction with skin graft was performed. The formal histopathological diagnosis after the wider resection was even more complex displaying three lines of differentiation, Squamous cell carcinoma, desmoplastic Spindle cell melanoma and Osteosarcoma with small component of rhabdomyoscarcoma. Unfortunately this aggressive and complex lesion then recurred a third time.
Results: To our knowledge no case as been reported such as this.
Conclusion: We will discuss the factors which may have contributed to this presentation, the histological perspective, the difficulty in treating such an aggressive lesion and what we can learn from this case for potentially treating similar cases in the future.
Rachel Enright1, Ger Kelly1, Jim Fitzgibbon2, Sean T O’Sullivan1
1 Plastic Surgery Department, Cork University Hospital, Cork
2 Histology Department, Cork University Hospital, Cork