Multinodular fibroepithelioma of Pinkus with an isolated focus of evolving basal cell carcinoma in chronic lymphedematous lower limb
Kaushik Majumdar1, Ujjawal Khurana2, Dinesh Asati3, Garima Goel2, Deepti Joshi2, Neelkamal Kapoor2
1 Department of Pathology, G.B. Pant Institute of Medical Education and Research, Jawaharlal Nehru Marg, New Delhi, India
2 Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
3 Department of Dermatology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
Department of Pathology, G.B. Pant Institute of Medical Education and Research, (Maulana Azad Medical College), Jawaharlal Nehru Marg, Academic Block, Room No. 323, New Delhi 110 002
Source of Support: None, Conflict of Interest: None
Fibroepithelioma of Pinkus (FEP) is a rare, indolent variant of basal cell carcinoma (BCC) with a unique anastomosing type of epidermal hyperplasia. Certain benign and neoplastic conditions including BCC are known to develop in a setting of chronic lymphedema. We report for the 1 st time the histological spectrum of evolution of a large exophytic multinodular FEP, bearing a single initiating focus of BCC, in preexisting chronic lymphedema of the lower limb. The lesion possibly evolved from long-standing local immune suppression, and clinically resembled a high-grade carcinoma. Oozing lymphatic fluid may interfere with the success of skin grafting following wide local excision in a lymphedematous limb, thus offering a challenging scenario from the management point of view.