appendage tumours

Figure 20.29A, B).

Figure 20.29 Skin appendage tumours. (A) A sebaceous naevus with an associated basal cell carcinoma. (B) A multiple cylindroma, with a typically non-characteristic appearance.

Sebaceous carcinoma is an example of an uncommon potentially metastatic skin appendage tumour. These classically occur on the eyelid, diagnosed on biopsy. Surgery is the treatment of choice. Sweat gland carcinoma gives a similar indistinct clinical picture. These tumours usually present as an odd-looking BCC or SCC, with the diagnosis again not been made until excision biopsy has been done. Surgery is again the treatment of choice.

Paget’s disease can occur outwith the breast; extra mammary Paget’s disease. The most common site is the vulva. This condition, thought to arise from epithelial cells in an apocrine duct, looks like eczema. It can give rise to pruritus and ulceration and may spread to locoregional nodes and even metastasize systemically.

Further Reading

Locke J., Karimpour S., Young G., et al. Radiotherapy for epithelial skin cancer. Int J Radiat Oncol Biol Phys. 2001;51:748–755.

Petit J.Y., Avril M.F., Margulis A., et al. Evaluation of cosmetic results of a randomized trial comparing surgery and radiotherapy in the treatment of basal cell carcinoma of the face. Plast Reconstr Surg. 2000;105:2544–2551.

Bishop J.N., Bataille V., Gavin A., et al. The prevention, diagnosis, referral and management of melanoma of the skin: concise guidelines. Clin Med. 2007;7:283–290.

Balch C.M., Buzaid A.C., Soong S.J., et al. Final version of the America Joint Committee on Cancer staging system for cutaneous melanoma. J Clin Oncol. 2001;18:3635–3648.

Tsao H., Atkins M.B., Sober A.J. Management of cutaneous melanoma. N Engl J Med. 2004;351:998–1012.

Thompson J.F., Scolyer R.A., Kefford R.F. Cutaneous melanoma. Lancet. 2005;365:687–701.

Morrison W.H., Garden A.S., Ang K.K. Radiation therapy for non melanoma skin carcinomas. Clin Plast Surg. 1997;24:718–729.

Ott M.J., Tanabe K.K., Gadd M.A., et al. Multimodality treatment of Merkel cell carcinoma. Arch Surg. 1999;134:388–393.

Stelzer K.J., Griffin T.W. A randomised prospective trial of radiation therapy for AIDS-associated Kaposi’s sarcoma. Int J Radiat Oncol Biol Phys. 1993;27:1057–1061.

Hersh E., Weber J., Powderly J., et al. Long-term survival of patients (pts) with advanced melanoma treated with ipilimumab with or without dacarbazine. Int J Clin Oncol. 2009;27:15s. (suppl; abstr 9038)

Hodi F.S., O’Day S.J., McDermott D.F., et al. Improved Survival with Ipilimumab in Patients with Metastatic Melanoma. N Engl J Med. 2010;363:711–722.

Chapman P.B., Hauschild A., Robert C., et al. Improved Survival with Vemurafenib in Melanoma with BRAF V600E Mutation. N Engl J Med. 2011;364:2507–2516.

Burmeister B.H., Mark Smithers B., Burmeister E., et al. A prospective phase II study of adjuvant postoperative radiation therapy following nodal surgery in malignant melanoma: Trans Tasman Radiation Oncology Group (TROG) study 96.06. Radiother Oncol. 2006;812:136–142.

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