Case Presentation
A 93-year-old Caucasian male patient came to our observation after undergoing resection of a grayish-yellow polypoid neoplasm with irregular contours and 2.5-cm maximum diameter in the skin of the distal third of the left arm approximately 8 months ago.
Originally, the neoplasm was mobile, with a brownish-red color, an irregularly circular base, and a maximum diameter of less than one centimeter, and asymptomatic (Fig. 1). Following rapid growth, the patient underwent surgical excision of a skin and subcutis lozenge measuring 5.5 × 2.3 × 1.5 cm under local anesthesia with lidocaine. Histological examination revealed a largely ulcerated and necrotic PC infiltrating the papillary dermis and the first portion of the reticular dermis (Fig. 2).
On clinical examination, the patient, transported in a wheelchair due to a severe degenerative joint disease limiting walking, had a very poor general condition, a ECOG (Eastern Cooperative Oncology Group) PS (performance status) of 3, and declining edema without other skin lesions or palpable superficial lymphadenopathy.
The histological picture and clinical history made it possible to formulate the diagnosis of PC that probably arose on a pre-existing poroma. Ultrasound of the abdomen and main lymph nodes and a chest X-ray were normal, excluding metastases.
Considering the patient’s age, poor general condition, comorbidities, and absent distant metastasis, periodic checks in the dermatological clinic were indicated. Written informed consent was obtained from the patient for publication of this case report and accompanying images.