A 67-year-old Chinese man noticed a small papula on the right side of his neck. One and a half months later, it became an erythematous plaque with a diameter of 2 cm. There was a crust in the center and multiple 2 mm size yellow-white milia-like lesions overlying the palque. The partial biopsy showed several follicular cysts containing laminated keratine in the upper dermis. We diagnosed the case as milia en plaque. After one week, new red papule appeared beside the plaque and rapidly became larger. In the histopathalogical examination, a scanning view showed numerous nests and infundibular cysts of various shapes. And these nests extended down to the middle of the dermis in irregular shapes. The cellular atypia of the neoplastic cells was moderate. Therefore, we diagnosed this case as infundibulocystic squamous cell carcinoma (SCC). Infundibulocystic SCC is associated with infundibular proliferation. There is a variant that has irregular infundibulocystic lobules in the dermis. [Skin Cancer (Japan) 2015 ; 30 : 1-5]

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Pazopanib and sorafenib are oral molecularly targeted agents that block multiple tyrosine kinase such as vascular endothelial growth factor receptor. Although these two seem effective for angiosarcoma, no published quantitative data has been available to date. The aim of this study is to explore the efficacy of MTT of pazopanib and sorafenib for angiosarcoma using clinical data in our facility. The study sample consisted of 4 men and 5 women with a mean age of 71.2 +/- 12.4 years. Primary tumor sites were one for the chest and 8 for the scalp. Two received sorafenib and 7pazopanib. The maximum response was 2 complete remissions (22%), 4 partial responses (44%) and 3 stable disease (33%). The progress free survival was 11.9 +/- 7.2 weeks. The data suggested satisfactory effects of pazopanib and sorafenib on tumor development. We further need to confirm the effects on survival rates. [Skin Cancer (Japan) 2015 ; 30 : 6-9]

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The patient was a 70-years-old Peruvian woman whose HIV antibody was negative. She immigrated to Japan 15 years ago. The patient had prednisone therapy due to erythema nodosum and then she was referred to our department due to multiple purple spots and nodules developing from edema of both legs. Skin biopsy specimens were obtained from the nodules. The histopathologic findings included abnormally proliferated and dilated vessels, vascular slits, numerous red blood cells, and spindle-shaped cells in the dermis. PCR examination by using skin tissue was positive for the specific band of HHV-8. The patient received treatment with liposomal doxorubicin hydrochloride (Doxil) at a dose of 20 mg/m² intravenously every 3 weeks for six cycles. HIV negative Kaposi sarcoma is particularly rare in Japan, because of the very small population ratios of HHP8-positive in Japanese. Liposomal doxorubicin hydrochloride is usually used in disseminated HIV-related Kaposi's sarcoma, while there have still been no reports of cases of Doxil for HIV negative Kaposi's sarcoma in Japan. We first report the HIV negative Kaposi's sarcoma treatment with Doxil with good tolerance and remission of the lesion. [Skin Cancer (Japan) 2015 ; 30 : 10-15]

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We report a rare case of undifferentiated pleomorphic sarcoma (UPS) causing mediastinal metastasis sequentially to multiple lung metastasis. A 52-year-old male noticed a mass on his right thigh, and a tumor with a 13 cm diameter. Resection and chemotherapy using MAID regimen was performed. However, lung metastasis was occured1 and a half years post-op, and partial lung resection was performed. Even though we administered ICE chemotherapy, lung metastasis recurred 8 months post-op, and additional lung resection was performed. 1 year later, metastasis to the mediastinal lymph node, and then, lymph node dissection was performed. We administered caffeine-potentiated chemotherapy ; however, this caused superior vena cava syndrome due to the recurrence of mediastinal lymph node metastasis, and, finally, metastasis to the heart occurred. Even though we tried multiple treatments, it was difficult to control and finally caused mediastinal metastasis which is rare for UPS. [Skin Cancer(Japan) 2015 ; 30 : 16-21]

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Eccrine porocarcinoma is a rare malignant neoplasm that presumably arises from the intraepidermal ductal portion of the eccrine sweat glands. We presented a case of a 69-year-old female with a tumor of 10 years' duration on her right buttock, which enlarged rapidly in the last 2 years. Physical examination revealed a 55 × 50 mm red, erosive tumor on the right side of her buttocks. She was treated with wide local excision with 10 mm surgical margins around the tumor. Histopathological findings were consistent with eccrine porocarcinoma with lymphovascular invasion, which is one of the predictive features of death resulting from eccrine porocarcinoma. Systemic examination showed multiple lymph node metastasis and carcinomatous lymphangitis ; therefore, she underwent adjuvant chemotherapy with docetaxel. [Skin Cancer (Japan) 2015 ; 30 : 22-25]

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A 63-year-old female patient underwent wide local excision after a diagnosis of malignant fibrous histiocytoma (MFH) on the left side of the chest. Thirteen years later, she noticed a painless enlarging subcutaneous mass in the left axillary region. CT showed local recurrence and metastasis of MFH to the axillary lymph nodes. A biopsy was performed. Histopathological and immunohistochemical examinations revealed the diagnosis of undifferentiated pleomorphic sarcoma (MFH). We performed axillary lymph node dissection. Histopathological examination of a resected specimen showed no residual tumor. The patient has been free from recurrence and metastasis 8 years postoperatively. Recurrence of MFH with an interval of 13 years is a rare event. To improve the prognosis of MFH, surgical prevention of local recurrence is essential. [Skin Cancer (Japan) 2015 ; 30 : 26-29]

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Compared to cutaneous malignant melanoma, mucosal melanoma is rare and has a poor prognosis. We report a case of mucosal malignant melanoma of the nasal cavity with transient but significant response to Carboplatin and Paclitaxel. The patient was a 66-year-old woman with extensive metastases involving bones, liver and submandibular lymph nodes. The metastases responded to systemic chemotherapy of Carboplatin (AUC 6) and Paclitaxel (200mg/m²) with drastic reduction of bone metastases, demonstrated by FDG-PET. However, she died of general prostration and meningitis carcinomatosa 11 months after the initiation of the chemotherapy. [Skin Cancer (Japan) 2015 ; 30 : 30-34]

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A case of a 74-year-old woman who visited our hospital because of a subucutaneous tumor on the back. She was operated on for a subucutaneous tumor on the back in 1995 with a diagnosis of a well-differentiated liposarcoma. Her condition repeated five times over the next 15 years. Histopathologically, the surgical specimen revealed proliferation of mature fat cell with differences in size. There were atypical lipoblasts in stroma. Reports of well-differentiated liposarcoma in the dermatology literature are rare. In addition, there are few reports of recurrenct cases. We report a recurrent case of well-differentiated liposarcoma including some consideration from literature. [Skin Cancer (Japan) 2015 ; 30 : 35-39]

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We report a case of squamous cell carcinoma (SCC) developing from recessive dystrophic epidermolysis bullosa, generalized other (RDEB-GO). When she was 35 years old, a tumor 8 cm in diameter appeared on a skin ulcer of the right back. We performed wide excision of the SCC and right axilla lymph node dissection ; we diagnosed SCC pT2N2M0, Stage IV (UICC 2009). Three months after the operation, metastases were observed at both axilla lymph nodes, and we performed lymph node dissection. Although postoperative radiation therapy was added to the treatment, the tumor was progressive, and she died at 11 months after the operation. RDEB patients often have SCC. About twenty percent of RDEB-GO patients develop SCC before 35 years of age, and 7 die because of SCC. As growth of cancer cells is very rapid, collective and comprehensive therapy is required for better outcome of SCC in RDEB. [Skin Cancer (Japan) 2015 ; 30 : 40-43]

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The occurrence of skin metastasis in patient with multiple myeloma is considered to be a poor prognostic sign. We report a 54-year-old man who was diagnosed with IgG-κ type multiple myeloma 8 months ago. He visited our department for several tumors on his head and trunk. A histopathological examination confirmed the diagnosis of metastases of multiple myeloma. The tumors regressed after combined chemotherapy and regional radiotherapy, but multiple skin tumors appeared despite the treatments. Finally he died 3 months after the initial diagnosis of skin metastasis. [Skin Cancer (Japan) 2015 ; 30 : 44-48]

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