Published online Jul 16, 2022. doi: 10.12998/wjcc.v10.i20.6960
Peer-review started: September 26, 2021
First decision: March 14, 2022
Revised: March 16, 2022
Accepted: May 26, 2022
Article in press: May 26, 2022
Published online: July 16, 2022
Processing time: 281 Days and 2.5 Hours
This paper introduces a case of recurrent keratoacanthoma (KA). KA is a self-healing disease. Recurrence after surgical resection is rare. In this case, the local application of retinoic acid ointment after the second operation achieved a good prognosis after 2 years of follow-up.
A 76-year-old male patient was admitted to the hospital for "lower lip rupture and scab for 3 mo". Treatment: A rectangular incision was made in the healthy tissue about 3 mm outside the periphery of the lower lip mass, and a modified Bernard sliding flap was designed to completely remove the mass. Pathology showed (lower lip) KA. When the patient returned 6 mo after surgery, the middle mucosa of the lower lip had a bulge with a diameter of about 0.5 cm. The boundary was still clear, the surface was ulcerated. A recurrence of lower lip KA was suspected and a fan-shaped incision was performed in the healthy tissue about 5 mm outside the lesion to completely resect. Pathological showed lower lip KA had recurred. Topical application of tretinoin cream was applied once a day for 3 mo. The lower lip wounds were clean at the 2-year postoperative follow-up and the mucosa was normal.
Adjuvant retinoic acid treatment after KA surgical resection can achieve good results.
Core Tip: Keratoacanthoma of the lower lip is a rare benign tumour with unique clinical and pathological characteristics which are very similar to those of well-differentiated squamous cell carcinoma of the lower lip. This article reports on an elderly male patient with recurrent lower lip keratoacanthoma, describing its clinical and pathological characteristics and treatment measures. Through reviewing the relevant literature and analysing the causes of the disease, clinical manifestations, pathological characteristics, treatment options, and causes of recurrence, it is possible to further deepen the understanding of the disease and help determine the diagnosis and treatment.