Solitary cutaneous neoplasms: analysing the uncertain behaviour with the aid of histopathology

BACKGROUND: Skin tumours can be classified as either benign or malignant, resulting due to the proliferation of one or more components of the skin. Reportedly, there has been a rise in the prevalence of skin cancer in recent decades, which has led to rely on histological evidence to distinguish between various types of skin cancer.

AIM: This study aims to provide a comprehensive description of the occurrence, symptoms, unpredictable nature, and range of histopathological spectrum in different types of skin tumours.

METHODS: This prospective research was conducted in the outpatient department of the Department of Dermatology at the Government General Hospital in Anantapur from July 2019 to July 2023. Patients who did not provide informed consent, those with infectious or cystic swellings, or those with multiple lesions were excluded from this study. Histopathological confirmation is obtained from all excisional biopsies of single cutaneous swellings, and tumours are classified based on the criteria established by the World Health Organization (WHO).

RESULTS: The study included a total of 123 individual cutaneous tumours, with 98 cases (79.67%) being classified as benign and 25 cases (20.32%) classified as malignant. The age group most affected is adults between the ages of 26 and 44, with a prevalence rate of 31.7%. Following closely behind are middle-aged individuals, with a prevalence rate of 30.08%. The males constitute 46.34% (57 cases) and the females constitutes 53.65% (66 cases). The extremities were the most frequently affected site, accounting for 53 cases (43.08%), followed by the head and neck region (29.26%). Based on the WHO classification of skin tumours, there were 42 cases (34.14%) of subcutaneous tissue tumours and 31 cases (25.20%) of soft tissue tumours. The prevalence of keratinocyte tumours is 26 (21.13%), whereas appendageal tumours account for 16 (13%) of cases. Melanocytic and neural tumours are the least prevalent, each representing 4 (3.25%) of cases. The majority of benign tumours arise from the subcutaneous tissues, whereas malignant tumours grow from keratinocytic differentiation.

CONCLUSION: Our study revealed that the majority of tumours displayed ambiguous clinical behaviour, which resulted in erroneous diagnoses. Hence confirmation by histopathology is crucial for accurate diagnosis and prompt management.