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 History
Figure 1 | | Translucent-appearing tumor of the groin
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A 68-year-old man presented with a protruding mass in his groin. He had worked as a blacksmith for fifty years. Thirty-five years ago he had a similar groin lesion biopsied in another hospital. It was diagnosed as "glandular epithelioma". He received soft X-ray therapy. The lesion reappeared five years later, and he was treated with cobalt radiation, with good results. Five years ago a basal cell carcinoma on the back was excised at our hospital. He did not return for follow-up until a slowly growing lesion on his groin, present for the last three years, brought him for consultation. Physical examination revealed a poikilodermatous area on his right groin, with a sessile, translucent-looking, soft tumor, not fixed to deep structures. He also had a lesion on his back diagnosed as Bowen's disease, and a superficial multifocal basal cell carcinoma on his thigh. General physical examination was normal.
Figure 2 |
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Figure 3 |
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Figure 2: Low power magnification shows a dermal tumor (HE, 6x).
Figure 3: The tumor is composed of "pale-staining lakes, with cellular islands". There are no inflammatory cells. (HE50x)
When cut for processing, the groin tumor was described as multinodular, with waxy and violaceus areas. It oozed a mucinous substance.
Figure 4 |
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Figure 5 |
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Figure 4: Ductal lumina and decapitation secretion are present. (HE, 100x)
Figure 5: Higher power magnification of the small round cells. Some of the cells show "decapitation" secretion or cytoplasm vacuolation. (HE, 400x)
Laboratory
The following results were negative or normal: Hemogram, biochemistry, chest-X-ray, barium enema, upper gastrointestinal series and thoracoabdominal computerized tomography. Electroneuromyography showed no signs of polyneuropathy. Arsenic levels in nails and pubic hair were normal.
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