This diabetic man presented with a three month history
of a large fungating tumour of the right lower lid. There was necrosis
in the centre of the lesion. The tumour resembled an aggressive squamous
cell carcinoma. However, histology of two incisional biopsies showed no
evidence of malignant cells. The dermatologist thought this may be a giant
keratoacanthoma. Due to the rapid growth of the lesion, an excisional biopsy
was performed. The microscopic examination of the excised lesion revealed
well-differentiated squamous cell carcinoma with involvement of the deep
layer. Further examination was performed of the deep tissue which showed
the tumour was completely excised.
|Fungating tumour of the lower
This case is a good example that incisional biopsy
may not provide adequate sample for an accurate diagnosis.
Closure of the defect was achieved with rotational
flap from the cheek and glabellar flap.