Fibroepithelioma of Pinkus Presenting as a Sessile Thigh Nodule

Abstract

A 68‐year‐old white man noticed the rapid enlargement of a newly appearing, painless lesion on his left leg during the previous month. There was no history of arsenic ingestion or local radiotherapy. A nontender, lobulated, sessile, red, 15×15×10 mm nodule protruded from the lateral side of his proximal right thigh (Figure 1). A tangential excision of the lesion was performed and the surgical site was allowed to heal by secondary intention. Microscopic examination showed anastomosing strands of basaloid cells extending from the overlying epidermis into the dermis (Figure 2). Some of the basaloid cells had atypical nuclei. Eccrine ducts were present within the strands of tumor cells. A fibromucinous stroma loosely surrounded the tumor. Focally, in the deeper portions of the tumor within the reticular dermis there was palisading of the peripheral row of cells and retraction of these tumor cells from the surrounding stroma (Figure 3). The tumor was completely removed in the sections examined. The pathologic changes were characteristic for the diagnosis of fibroepithelioma of Pinkus variant of basal cell carcinoma. Distant (A) and closer (B) views of a fibroepithelioma of Pinkus that presents on the patient's lateral right proximal thigh as a sessile nodule image Crusted polypoid nodule with a proliferation of anastomosing strands of basaloid epithelium embeded in abundant dense fibrous tissue (hematoxylin‐eosin stain, original magnification×4)image Another view shows some areas with stromal edema and focal retraction from the reticulated basaloid tumor (hematoxylin‐eosin stain, original magnification×4).image