The clinical features of rhinophyma can mask the existence or coexistence of a skin cancer. Many tumours can mimic rhinophyma. Many authors report cases of cancerisation of rhinophyma or the coexistence of rhinophyma and a cancer. Few authors have however reported cases of squamous cell carcinoma mimicking rhinophyma. We present the clinical case of a 48 year-old male with squamous cell carcinoma of the nose (tip of the nasal pyramid and vestibule), a histologic diagnosis after being confronted by an atypical clinical presentation of rhinophyma. Treatment consisted of radiation therapy and evolution was characterised by tumoral regression.
Rhinophyma is a pathology characterised by progressive deformation of the nose due to thickening of the dermis. It is socially difficult to live with as the size of the nose can quadruple. It is relatively frequent in caucacians but rare in blacks [
It was the case of Mr N., a 48 year old driver, resident in Douala, a known diabetic on oral treatment. He consulted for a swelling of the nose concerning the tip and the alae, evolving since 11 months.
Clinical examination revealed a tumefaction of the nasal tip and alae, about 4 cm in the main axis, having a nodular erythematous and bosselated appearance as shown in
An initial biopsy evoked a squamous cell carcinoma (SCC). A second biopsy was done due to doubts and still confirmed the diagnosis of a SCC, invasive and keratinising.
Due to insufficiency of our technical platform to do a plastic surgery for the nose, external radiation therapy was proposed following a multidisciplinary therapeutic decision-making reunion.
Rhinophyma is a hypertrophy of the dermis of the nose
of chronic evolution [
The term rhinophyma was given by Hebra in 1845 from the Greek words rhis (nose) and phyma (growth) [
The histological characteristics of rhinophyma are hyperplasia of the pilo-sebaceous glands, fibrosis, inflammation and the presence of telangiectasia [
Rhinophyma is common in the western world affecting men in the fifth to seventh decades of life [
Once the pathology diagnosis done, workup was done to search for another primitive site and for metastasis, with a chest radiograph and transaminases, all of which were normal.
The treatment of SCC of the nose is determined by the histological diagnosis [
The evolution on treatment was characterised by regression of the tumour.
Due to rareness of rhinophyma, we propose that in the case of suspicion of rhinophyma clinically, a biopsy should always be performed to roll out possibility of a malignancy which can be primitive or resulting from cancerisation of an underlying rhinophyma.