Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Premalignant Fibroepithelial Tumor (Pinkus Tumor) Clinical Presentation

  • Author: Darius Mehregan, MD; Chief Editor: Dirk M Elston, MD  more...
 
Updated: Mar 31, 2016
 

History

The tumor can present alone or in association with seborrheic keratoses and/or other basal cell carcinomas.

Its frequency is higher in areas of prior radiation-damaged epidermis.[9]

Reports have described two women who had an associated malignancy. One was found to have intraductal breast carcinoma underlying the fibroepithelioma of Pinkus,[10] and the other was found to have a perianal fibroepithelioma harboring Paget cells.[11]

Next

Physical

The fibroepithelioma of Pinkus usually presents as a slowly enlarging, fleshy, raised or pedunculated papilloma or sessile fibroma with a broad base, most commonly on the trunk or the extremities.

The color is usually pink or reddish, but, in some instances, a tinge of brown may be present.

It may be single or multiple and shows a strong predilection for the lumbosacral area. However, numerous cases have occurred elsewhere, including the head, the abdomen, the anus, the penis,[12] the breasts, and the scrotum.

This tumor can clinically resemble seborrheic keratosis, pedunculated fibroma, nevus sebaceus of Jadassohn, papillomatous melanocytic nevus, amelanotic melanoma, and neurofibroma.

Dermoscopy shows fine arborizing vessels alone or associated with dotted vessels and white streaks. Gray-brown areas of pigmentation and variable gray-blue dots may be observed.[13]

Previous
Next

Causes

Basal cell carcinomas are most commonly associated with chronic ultraviolet light exposure, previous radiation damage,[9] or prior ingestion of arsenic. Whether any of these predisposing factors is a relevant cause of fibroepithelioma of Pinkus is unproven.

Previous
 
 
Contributor Information and Disclosures
Author

Darius Mehregan, MD Associate Professor, Hermann Pinkus Chairman of Dermatology, Department of Dermatology, Wayne State University School of Medicine; Clinical Associate Professor of Pathology, University of Toledo College of Medicine; Dermatopathologist, Pinkus Dermatopathology Laboratory; Consulting Staff, Department of Dermatology, J Dingell Veterans Affairs Medical Center

Darius Mehregan, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society of Dermatopathology, International Society of Dermatology, International Society of Dermatopathology, Phi Beta Kappa, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Coauthor(s)

Jennifer Michelle Heyl, MD Resident Physician, Department of Dermatology, Wayne State University School of Medicine

Disclosure: Nothing to disclose.

Rahil M Dharia Wayne State University School of Medicine

Rahil M Dharia is a member of the following medical societies: American Association of Physicians of Indian Origin, American Medical Association, American Medical Student Association/Foundation, Association of Students for Hinduism Awareness, Michigan Association of Physicians of Indian Heritage

Disclosure: Nothing to disclose.

Specialty Editor Board

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Rosalie Elenitsas, MD Herman Beerman Professor of Dermatology, University of Pennsylvania School of Medicine; Director, Penn Cutaneous Pathology Services, Department of Dermatology, University of Pennsylvania Health System

Rosalie Elenitsas, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society of Dermatopathology, Pennsylvania Academy of Dermatology

Disclosure: Received royalty from Lippincott Williams Wilkins for textbook editor.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Maureen B Poh-Fitzpatrick, MD Professor Emerita of Dermatology and Special Lecturer, Columbia University College of Physicians and Surgeons

Maureen B Poh-Fitzpatrick, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, New York Academy of Medicine, New York Dermatological Society

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author, David Pegouske MD, to the development and writing of this article.

References
  1. Pinkus H. Premalignant fibroepithelial tumors of skin. AMA Arch Derm Syphilol. 1953 Jun. 67(6):598-615. [Medline].

  2. Matsumura Y, Nishigori C, Yagi T, Imamura S, Takebe H. Characterization of p53 gene mutations in basal-cell carcinomas: comparison between sun-exposed and less-exposed skin areas. Int J Cancer. 1996 Mar 15. 65(6):778-80. [Medline].

  3. Aszterbaum M, Rothman A, Johnson RL, Fisher M, Xie J, Bonifas JM, et al. Identification of mutations in the human PATCHED gene in sporadic basal cell carcinomas and in patients with the basal cell nevus syndrome. J Invest Dermatol. 1998 Jun. 110(6):885-8. [Medline].

  4. Sellheyer K, Nelson P, Kutzner H. Fibroepithelioma of Pinkus is a true basal cell carcinoma developing in association with a newly identified tumour-specific type of epidermal hyperplasia. Br J Dermatol. 2012 Jan. 166(1):88-97. [Medline].

  5. Tarallo M, Cigna E, Fino P, Lo Torto F, Corrias F, Scuderi N. Fibroepithelioma of Pinkus: variant of basal cell carcinoma or trichoblastoma? Case report. G Chir. 2011 Jun-Jul. 32(6-7):326-8. [Medline].

  6. Ioannidis O, Papaemmanuil S, Kakoutis E, Papadopoulos G, Chatzopoulos S, Kotronis A, et al. Fibroepithelioma of pinkus in continuity with nodular basal cell carcinoma: supporting evidence of the malignant nature of the disease. Pathol Oncol Res. 2011 Mar. 17(1):155-7. [Medline].

  7. Stern JB, Haupt HM, Smith RR. Fibroepithelioma of Pinkus. Eccrine duct spread of basal cell carcinoma. Am J Dermatopathol. 1994 Dec. 16(6):585-7. [Medline].

  8. Pan Z, Huynh N, Sarma DP. Fibroepithelioma of pinkus in a 9-year-old boy: a case report. Cases J. 2008. 1(1):21. [Medline].

  9. Hartschuh W, Schulz T. Merkel cell hyperplasia in chronic radiation-damaged skin: its possible relationship to fibroepithelioma of Pinkus. J Cutan Pathol. 1997 Sep. 24(8):477-83. [Medline].

  10. Bryant J. Fibroepithelioma of Pinkus overlying breast cancer. Arch Dermatol. 1985 Mar. 121(3):310. [Medline].

  11. Warner TF, Burgess H, Mohs FE. Extramammary Paget's disease in fibroepithelioma of Pinkus. J Cutan Pathol. 1982 Oct. 9(5):340-4. [Medline].

  12. Heymann WR, Soifer I, Burk PG. Penile premalignant fibroepithelioma of Pinkus. Cutis. 1983 May. 31(5):519-21. [Medline].

  13. Zalaudek I, Leinweber B, Ferrara G, Soyer HP, Ruocco E, Argenziano G. Dermoscopy of fibroepithelioma of pinkus. J Am Acad Dermatol. 2005 Jan. 52(1):168-9. [Medline].

  14. Naeyaert JM, Pauwels C, Geerts ML, Verplancke P. CD-34 and Ki-67 staining patterns of basaloid follicular hamartoma are different from those in fibroepithelioma of Pinkus and other variants of basal cell carcinoma. J Cutan Pathol. 2001 Nov. 28(10):538-41. [Medline].

  15. Katona TM, Ravis SM, Perkins SM, Moores WB, Billings SD. Expression of androgen receptor by fibroepithelioma of Pinkus: evidence supporting classification as a basal cell carcinoma variant?. Am J Dermatopathol. 2007 Feb. 29(1):7-12. [Medline].

  16. Fecher LA, Sharfman WH. Advanced basal cell carcinoma, the hedgehog pathway, and treatment options - role of smoothened inhibitors. Biologics. 2015. 9:129-40. [Medline].

  17. Mehregan AH. Proliferation of sweat ducts in certain diseases of the skin. Am J Dermatopathol. 1981. 3(1):27-31. [Medline].

 
Previous
Next
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.