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Multinodular fibroepithelioma of Pinkus with an isolated focus of evolving basal cell carcinoma in chronic lymphedematous lower limb


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

Correspondence Address:
Kaushik Majumdar,
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
India
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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.


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