Track: Case Reports

Abstract:

Clear cell acanthoma (CCA), or Degos acanthoma, is a benign, epidermal tumor of a debated cell of origin, usually occurring in middle-aged to late-aged patients. The typical presentation is a smooth, dome-shaped pink or red nodule, measuring 10-15 mm on the lower extremities. However, rare variants have been reported with features such as pigmentary changes and various unusual clinical features. Giant CCAs, presenting as a larger mass, are an extremely rare variant that can be clinically mistaken for a lipofibroma. Herein, we describe this unusual clinical presentation of a giant CCA, measuring 45 x 20 mm on the thigh of a 41-year-old female. An excisional biopsy was performed, and diagnosis was established through histopathologic evaluation. Histopathological analysis revealed a large well-demarcated tumor with psoriasiform epidermal hyperplasia comprised of pale-staining, glycogen-rich cells and overlying parakeratosis with neutrophilic microabscesses. Similar reported sizes of giant CCAs are scarce, with only a limited number of cases exceeding 30–40 mm described in the literature. This unique case of a giant CCA highlights the histopathologic pearls and clinical features of this rare presentation of an uncommon epidermal neoplasm.

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Katherine Woolridge