Papillary immature metaplasia (PIM) demonstrates a bottom-heavy pattern in most exophytic
lesions (B), but flat-topped lesions that consisted largely of basaloid cells demonstrate diffuse expression throughout the entire squamous epithelia (C).
On examination, a 1.5 cm diameter exophytic
midline tongue lesion (Figure 1) was noted.
The tumors are slow-growing and exophytic
, eventually developing a bulky polypoid, cauliflower-like appearance .
Clinical examination revealed several plaques and striated white lesions on the tongue and in the left and right buccal mucosae (Figure 1(b)) and an exophytic
tumor with a smooth whitish surface on the left buccal mucosa.
The lesion originated from the hepatic segment V-VI and gave off exophytic
extensions in the posterior-inferior direction, and it contained hypodense areas (daughter vesicles) (Figures 1(a)-1(c)).
Nasopharyngeal papillary adenocarcinoma may appear grossly as an exophytic
, nodular, or polypoid mass, sometimes gritty if psammoma bodies are present.
The diagnosis of PGs is based on the characteristic history of a rapidly growing, red to purple nodule that frequently bleeds and often ulcerates, accompanied by the physical findings of a typical exophytic
, friable, vascular lesion.
A computed tomography (CT) scan revealed soft-tissue density measuring approximately 3 cm in diameter on the posterolateral wall of the left nasopharynx, obstructing the lumen and showing exophytic
growth towards the lumen.
Different histological groups of penile neoplasms with an exophytic
papillary lesions including WC are collectively referred to as the "verruciform" group of neoplasms [2,12].
Moreover the MRI confirmed the bladder thickening, more evident in the lower third of the bladder where it was associated with an exophytic
lesion (Figure 2).
Lesions of eccrine poroma are often not clinically distinctive, and have been described as exophytic
growths measuring 1-5cm in diameter, sessile or slightly pedunculated with normal or erythematous color and a firm consistency.1,2,4Ulceration may occur at points of pressure.1,2The clinical differential diagnosis includes pyogenic granuloma, keratoacanthoma, squamous cell carcinoma, basal cell carcinoma.1,2,10It is thus not entirely surprising that in our patient, the initial clinical impression was that of a keratoacanthoma.
Indication for radical nephrectomy was the volume and the location of the tumour (not exophytic
, nearness to the vascular pedicle).