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.