Giant Koenen Tumors as the Presenting and Only Clinical Sign of Tuberous Sclerosis Complex in a 56-Year-Old Man and Its Surgical Management

Log in to MyKarger to check if you already have access to this content.

Buy FullText & PDF Unlimited re-access via MyKarger Unrestricted printing, no saving restrictions for personal use
read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!

If you would like to redeem your KAB credit, please log in.

Save over 20% compared to the individual article price.

Learn more

Rent/Cloud Rent for 48h to view Buy Cloud Access for unlimited viewing via different devices Synchronizing in the ReadCube Cloud Printing and saving restrictions apply Rental: USD 8.50
Cloud: USD 20.00

Select

Subscribe Access to all articles of the subscribed year(s) guaranteed for 5 years Unlimited re-access via Subscriber Login or MyKarger Unrestricted printing, no saving restrictions for personal use read more

Subcription rates

Select

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview

Abstract of Novel Insights from Clinical Practice

Received: February 16, 2022
Accepted: April 27, 2022
Published online: May 23, 2022

Number of Print Pages: 5
Number of Figures: 3
Number of Tables: 0

ISSN: 2296-9195 (Print)
eISSN: 2296-9160 (Online)

For additional information: https://www.karger.com/SAD

Abstract

Introduction: Tuberous sclerosis complex (TSC) is a genetic multisystem disorder with prominent skin involvement. Multiple ungual fibromas, also known as Koenen tumors (KTs), are one of the major diagnostic criteria and occur approximately in 50% of patients with TSC. They are disfiguring, painful, and challenging to treat as they frequently recur. There are 2 previous cases in the literature of KTs as the only clinical sign of TSC. Case Presentation: A 56-year-old male patient with intellectual disability presented with a history of ungual growths that had gradually increased in size and number for 20 years. The diagnosis of KTs was established on clinical grounds, without the requirement of histological confirmation. No additional clinical evidence of TSC was found. Complete surgical excision of the tumors located in the proximal nail matrix, periungual folds, and nail bed of each toe was successfully performed. Discussion: The association between KTs and intellectual disability with TSC supported the clinical diagnosis. To date, there is no standard first-line treatment for KTs. Complete surgical excision up to the proximal base of the tumor offers satisfactory results in terms of functionally and esthetic appearance and could be considered the preferred therapeutic modality for patients with severe functional and cosmetic impairment. Prompt recognition of the many signs and symptoms associated with TSC is important to achieve early diagnosis, preventing further complications.

© 2022 S. Karger AG, Basel

References Portocarrero LKL, Quental KN, Samorano LP, Prado de Oliveira ZN, Rivitti-Machado MC da M. Tuberous sclerosis complex: review based on new diagnostic criteria. An Bras Dermatol. 2018 Jun;93(3):323–31. Johnson RE, Avramaut K. Pedal cutaneous manifestations of tuberous sclerosis. J Am Podiatr Med Assoc. 2017 Jul;107(4):324–8. Ebrahimi-Fakhari D, Meyer S, Vogt T, Pföhler C, Müller CSL. Dermatological manifestations of tuberous sclerosis complex (TSC). J Dtsch Dermatol Ges. 2017 Jul;15(7):695–700. Cardis MA, Deklotz CMC. Cutaneous manifestations of tuberous sclerosis complex and the paediatrician’s role. Arch Dis Child. 2017 Sep;102(9):858–63. Randle SC. Tuberous sclerosis complex: a review. Pediatr Ann. 2017 Apr;46(4):e166–71. Malissen N, Vergely L, Simon M, Roubertie A, Malinge MC, Bessis D. Long-term treatment of cutaneous manifestations of tuberous sclerosis complex with topical 1% sirolimus cream: a prospective study of 25 patients. J Am Acad Dermatol. 2017 Sep;77(3):464–72.e3. Martínez Campayo N, Taibo Martínez A, Del Pozo Losada J, Fonseca E. Shave and carbon dioxide laser vaporization of ungual fibromas, Koenen’s tumors, in five patients with tuberous sclerosis. Dermatol Ther. 2021 Jan;34(1):e14571. Liebman JJ, Nigro LC, Matthews MS. Koenen tumors in tuberous sclerosis: a review and clinical considerations for treatment. Ann Plast Surg. 2014 Dec;73(6):721–2. Viswanath V, Gupte JD, Prabhu N, Gour NL. Multiple koenen tumors, a rare entity: combination treatment with 1% topical sirolimus electrofulguration and excision. Ski Appendage Disord. 2021 Jan;7(1):66–70. Webb DW, Clarke A, Fryer A, Osborne JP. The cutaneous features of tuberous sclerosis: a population study. Br J Dermatol. 1996;135(1):1–5. Henske EP, Jóźwiak S, Kingswood JC, Sampson JR, Thiele EA. Tuberous sclerosis complex. Nat Rev Dis Primers. 2016 May 26;2:16035. Aryal E, Bastakoti S, Bhatarria S, Shrestha SB, Pokhrel G. Koenen tumors 20 nail involvement: a rare case report. Ann Clin Case Rep. 2017 Aug;2:1411. Ruiz-Villaverde R, Blasco-Melguizo J, Hernández-Jurado I, Naranjo-Sintes R, Gutierrez Salmerón MT. Bilateral and multiple periungual fibromas as an oligosymptomatic form of tuberous sclerosis. Dermatology. 2004;209(2):160–1. Hasbani DM, Crino PB. Tuberous sclerosis complex. Handb Clin Neurol. 2018;148:813–22. Northrup H, Krueger DA, Roberds S, Smith K, Sampson J, Korf B, et al. Tuberous sclerosis complex diagnostic criteria update: recommendations of the 2012 international tuberous sclerosis complex consensus conference. Pediatr Neurol. 2013 Oct;49(4):243–54. Ruiz Villaverde R, Blasco Melguizo J, Delgado Ceballos F, Buendia Eisman A, Delgado Florencio V. Homage to reverdin: pinch grafting. J Eur Acad Dermatol Venerol. 2003 Jan;17(1):111–3. Reddy IS, Somani VK. Giant periungual and subungual fibromas (Koenen’s tumor) of tuberous sclerosis complex. Indian J Dermatol Venereol Leprol. 2021 May;8:1–2. Jindal R, Dvivedi S, Sethi S. Giant Koenen tumors involving 20 nails. Indian J Dermatol Venereol Leprol. 2021 Sep–Oct;87(5):734–5. Quist SR, Franke I, Sutter C, Bartram CR, Gollnick HP, Leverkus M. Periungual fibroma (Koenen tumors) as isolated sign of tuberous sclerosis complex with tuberous sclerosis complex 1 germline mutation. J Am Acad Dermatol. 2010 Jan;62(1):159–61. Çiğdem Oba M, Uzunçakmak TK, Sar M, Serdaroğlu S. Dermoscopic findings in a case of multiple subungual fibromas. Acta Dermatovenerol Alp Pannonica Adriat. 2021 Mar;30(1):35–7. Oliveira GB, Rossi NCP, Cury DO, Coura MGC, Antonio CR. Exuberant koenen tumors: effective treatment with amputation of the nail apparatus and reconstruction with fullthickness skin grafts. Surg Cosmet Dermatol. 2017;9(2):187–9. Article / Publication Details

First-Page Preview

Abstract of Novel Insights from Clinical Practice

Received: February 16, 2022
Accepted: April 27, 2022
Published online: May 23, 2022

Number of Print Pages: 5
Number of Figures: 3
Number of Tables: 0

ISSN: 2296-9195 (Print)
eISSN: 2296-9160 (Online)

For additional information: https://www.karger.com/SAD

Copyright / Drug Dosage / Disclaimer Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

留言 (0)

沒有登入
gif