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December 1982

Squamous Cell Carcinoma Arising in an Epidermal Cyst

Author Affiliations

Cambridge, Mass

Arch Dermatol. 1982;118(12):961. doi:10.1001/archderm.1982.01650240005006

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To the Editor.—  I would like to reiterate the warning of Dr Miller in his letter in the November 1981 Archives (117:683) entitled "Squamous Cell Carcinoma Arising in an Epidermal Cyst."

Report of a Case.—  A 58-year-old man was initially seen with a mass that was present in his right ear for 11 years. The lesion was a cystic 2 × 2.5-cm fluctuant area that I drained. A biopsy of the mass was done with the patient under local anesthesia. The report disclosed a "ruptured epidermal thick-walled cyst with foreignbody reaction." Following incision, drainage, and biopsy, the cyst wall seemed rigid and did not collapse despite warm compresses and treatment with antibiotics. Because of continued rigidity of the lesion and failure to resolve, I urged excision of the area in toto, which was done. To my amazement, the pathologist in the second hospital sectioning the mass found squamous cell carcinoma

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