PMC6806623_01
Preoperative findings. A 70-year-old man with a tumor (7x7 cm) on his buttock.
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F1
A 70-year-old man presented with a mass on his right buttock, which measured 7 x 7 cm in diameter (Fig 1), and a swelled right inguinal lymph node.
(a) Axial T1-weighted MRI scan of the tumor. (b) Axial T2-weighted MRI scan of the tumor. (c) Sagittal T1-weighted MRI scan of the tumor. (d) Sagittal T2-weighted MRI scan of the tumor.
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F2
Magnetic resonance imaging showed that it had invaded the subcutaneous region (Figs 2a-2d).
(a) Design of the operation. (b) Image obtained after the tumor was resected.
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F3
We excised it with a 3-cm surgical margin and the muscle fascia, as well as the swelled lymph node (Figs 3a and 3b).
(a) Epithelial findings. The epithelium of the squamous cell carcinoma is contiguous with the epithelium of the epidermal cyst (hematoxylin and eosin staining, bar: 5 mm). (b) Cellular findings. Numerous keratinized atypical cells are seen. The atypical cells have formed nests and cancer pearls (hematoxylin and eosin staining, bar: 1 mm). (c) Postoperative findings obtained after the skin grafting. (d) Postoperative 6-month findings.
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F4
Histopathologically, this case was diagnosed as a squamous cell carcinoma arising from an epidermal cyst and right inguinal lymph node metastasis, because the epithelium of the squamous cell carcinoma was contiguous with the epithelium of the epidermal cyst (Figs 4a and 4b). A skin graft and lymph node dissection were performed (Fig 4c). There was no recurrence of the tumor (Fig 4d).