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The relationship between basal cell epithelioma and seborrheic keratosis. A study of 60 cases.

BACKGROUND
Various skin tumors can be seen rarely in association with seborrheic keratosis. We present 60 cases of seborrheic keratosis related to a basal cell epithelioma in the same specimen.


OBJECTIVE
To report association of basal cell epithelioma with seborrheic keratosis and discuss the possibility of malignant change in seborrheic keratosis.


METHODS
Sixty cases of seborrheic keratosis associated with basal cell epithelioma were studied. Tissues were fixed in neutral buffered formalin, processed, and stained with standard hematoxylin and eosin techniques.


RESULTS
Histological evaluation showed a seborrheic keratosis associated with basal cell epithelioma in all of the cases. Basal cell epithelioma was attached with seborrheic keratosis in a majority of the cases (40/60) and appeared to represent a part of the same tumor. Both tumors were lying adjacent to each other in the rest of the cases (20/60).


CONCLUSION
Malignant change in seborrheic keratosis is controversial. We recommend the histological evaluation of seborrheic keratosis especially when inflamed or atypical in appearance. This should not be taken as a mandate for pathological evaluation or for treatment of every seborrheic keratosis as though it was potentially malignant.