Giant Papilloma OR Nevus Lipomatosus Superficialis: An Incidental Finding in a Patient with Chronic Obstructive Pulmonary Disease
Correspondence Address :
Puja Upadhyay,
Room No. T17, Radhikabai Hostel, JNMC, Sawangi (Meghe), Wardha-442107, Maharashtra, India.
E-mail: pujaupadhyay7@gmail.com
A 65-year-old female presented to the Department of Respiratory Medicine with chief complaints of breathlessness {modified Medical Research Council (mMRC) Dyspnoea Scale Grade 2} (1) for seven days and cough with mucoid expectoration for 15 days. She was a known case of Chronic Obstructive Pulmonary Disease (COPD) and was on regular medication for the same. On general examination, a mass-like structure was seen protruding from her middle back. Upon further inspection, it was identified as a cauliflower-like mass, approximately 10x15 cm in size, with a stalk (Table/Fig 1). The mass had a smooth surface and was skin-coloured, painless, and non tender. No foreign body was present. The patient first noticed the mass two years ago, while bathing. Initially, it was a small non tender swelling the size of a pea, which gradually grew to its present size. The mass did not cause any pain or disruption in daily activities, except for minimal discomfort , while lying on her back due to its size. As a result, the patient did not seek medical attention for it. Surgery and dermatology opinions were obtained, and a working diagnosis of squamous cell papilloma vs nevus lipomatosus cutaneous superficialis was made. The patient declined surgical intervention, and thus, a confirmed histopathological diagnosis could not be established.
A papilloma is a benign non cancerous tumour that originates from an epithelial surface and typically grows outward (2). Squamous cell papillomas, which appear as frond-like tumours, can develop on various parts of the body with squamous epithelium. Most of these lesions are caused by the Human Papillomavirus (HPV) and are contagious upon contact, except for cutaneous papillomas. In immunocompetent patients, papillomas are usually self-limiting (3). Nevus lipomatosus cutaneous superficialis is a benign hamartoma of the skin. It is a rare tumour with an unknown cause and is a cosmetic defect that produces no symptoms or discomfort. There are two major types: multiple or classic type with segmentally distributed multiple lesions, and solitary type presenting as a solitary papule or nodule (4),(5). It is characterised by the presence of mature adipocytes in the reticular dermis without involvement of the underlying subcutaneous tissue. Both squamous cell papilloma and nevus lipomatosus cutaneous superficialis are mostly asymptomatic conditions that do not cause discomfort to the patient. If treatment is required or desired, surgical excision is performed, and confirmation of diagnosis is done through histopathological examination. In a case report by Mehdiratta S et al., a similar lesion was discussed on the gluteal region in a 69-year-old male. The lesion was a single, soft, well-defined, skin-coloured, cerebriform pedunculated mass measuring 4.5×3.5×2 cm. The lesion grew slowly and gradually, was painless, and not associated with inflammation or discomfort, which is similar to the findings in the present case. Mehdiratta S et al., made a working diagnosis of papilloma and an excisional biopsy was performed (6). The histopathological examination revealed the diagnosis of nevus lipomatosus cutaneous superficialis.
Benign tumour, Cauliflower-like growth, Hamartoma, Human papillomavirus
DOI: 10.7860/JCDR/2023/65394.18389
Date of Submission: May 12, 2023
Date of Peer Review: May 29, 2023
Date of Acceptance: Jun 30, 2023
Date of Publishing: Sep 01, 2023
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: May 16, 2023
• Manual Googling: Jun 02, 2023
• iThenticate Software: Jun 23, 2023 (16%)
ETYMOLOGY: Author Origin
EMENDATIONS: 6
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