PMC8687443_01
Main clinical manifestations. (A and B) Multiple plaques, maculopapules, atrophic scars with bulged edges and partial ulcerated skin lesions on his face; (C and D) Facial skin lesions after 8 sessions of 5-aminolevulinic acid photodynamic therapy.
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Physical examination revealed absent right-ear lobe, asymmetrical black plaques, maculopapules, atrophic scars with bulged edges and partially ulcerated skin lesions on his face and back (Figure 1A and B). Most of the facial lesions improved substantially after eight ALA-PDT sessions within three and a half months (Figure 1C and D).
Radiographic findings. (A) Panoramic radiograph of the oral cavity revealed multiple odontogenic keratocysts; (B) Skull computed tomography showed calcification of the falx cerebri; (C-F) Contrast-enhanced computed tomography of the abdomen revealed mesenteric and para-aortic nodules, bilateral renal cysts (the right one-Bosniak grade III).
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The panoramic radiograph of the oral cavity showed multiple odontogenic keratocysts (Figure 2A). Skull computed tomography (CT) found falx cerebri and tentorium cerebellum calcification (Figure 2B). CT of the abdomen showed bilateral renal cysts, mesenteric and para-aortic nodules (Figure 2C-F). Chest CT, echocardiography and spine X-ray were unremarkable.
Histopathology of three skin lesions: discrete nests of basaloid cells in the dermis, the peripheral cells are arrayed like a palisade (orange arrows). Adjacent stromal retractions with empty space formations were also noticed (red arrows). Mucin existed among the tumor masses (blue arrow). (hematoxylin eosin, original magnificationx40/100). (A-D) face. (E-F) back.
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An amount of mucin surrounding the tumor masses existed (Figure 3A-F).