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Journal of Cancer Research and Therapeutics, Vol. 2, No. 4, October-December, 2006, pp. 200 Case Report Squamous cell carcinoma over a nevus: A rare case Patro KC, Padhi S, Singh DN Acharya Harihar Regional Cancer Centre, Cuttack, Orissa Code Number: cr06047 Abstract Malignant melanoma and basal cell carcinoma are more common over a preexisting nevus. But squamous cell carcinoma over a nevus is a rare phenomenon. A 55-year-old male presented with a slow growing noduloulcerative lesion on a preexisting nevus over scalp. For that he had undergone excisional biopsy. Biopsy came out to be a squamous cell carcinoma with lateral margin positive for tumor. So postoperative radiotherapy given by means of HDR brachytherapy. Now he is on follow-up. Keywords: Nevus, squamous cell carcinoma Introduction Among the various cutaneous malignancies, basal cell carcinoma out numbers melanoma and squamous histology. They mainly arise from sun exposure area particularly scalp and face. Malignant melanoma and basal cell carcinoma are two conditions can occur in preexisting nevus. Squamous histology is very rare over a preexisting nevus. There are no earlier reports on this and also no material available in books.Case report A 55-year-old male presented with an ulceronodular lesion over a preexisting nevus at the Regional Cancer Centre, Cuttack. Gross examination revealed a 2x2 cm dimension of noduloulcerative lesion over a nevus of 4x5 cm dimension on scalp. According to the patient, the nevus was small in size but gradually increasing in all directions in the last one yr to reach the existing new size. But the patient noticed a ulceronodular lesion in the last one month over central part of the growing nevus. That initiated the patient to meet the physician. Then he had undergone local excision of that noduloulcerative lesion but no treatment to nevus on histology. It came out to be a squamous cell carcinoma with lateral margin positive of tumor. For that patient treated with postoperative radiotherapy by means of HDR brachytherapy of total dose 59 Gy LDR equivalent @ 3Gy/ fraction and 2 fractions per day at 6h interval. Now the patient is on follow-up.Discussion The present case report reveals an unusual presentation. Malignant melanoma occurs in preexisting nevus like common nevi,[1] atypical nevi,[2] dysplastic nevi,[3] congenital nevi.[4] But no case reports have been reported about squamous cell carcinoma over a nevus. There is also no book data available till date. Though malignant melanoma and basal cell carcinoma are reported over preexisting nevus. After the reporting of this case one should not overlook the squamous histology over a nevus. References
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