Chondrodermatitis Nodularis Chronica Helicis Mimicking Metastazis
Ali Cengiz*, Hasan Erdogan, Muhsin Nuh Aybay, Mehmet Sedat Durmaz, Fatma Zeynep Arslan, Özgür Öner and Arzu Cengiz
Department of Radiology, University of Health Sciences, Konya Education and Research Hospital, Turkey
*Corresponding author: Ali Cengiz, MD, Assistant, Department of Radiology, University of Health Sciences, Konya Education and Research Hospital, Konya, 42090, Turkey, Tel: +90332-22100-00, Fax: +90-332-323-67-23, E-mail: email@example.com
Clin Med Img Lib, CMIL-2-056, (Volume 2, Issue 8); ISSN: 2474-3682
Published: November 18, 2016
Citation: Cengiz A, Erdogan H, Aybay MN, Durmaz MS, Arslan FZ, et al. (2016) Chondrodermatitis Nodularis Chronica Helicis Mimicking Metastazis. Clin Med Img Lib 2:056.
Copyright: © 2016 Cengiz A, et al. This is an open-access content distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original authorand source are credited.
A 66-year-old male patient who underwent operation on the left temporal region due to squamous cell cancer and has been followed for a year admitted to our hospital for right ear swelling and ear pain which is worse at night. Physical examination showed patient had slight swelling of the right auricular helix. Laboratory findings was normal. Contrast magnetic resonance imaging (MRI) is performed on patient with history of malignancy because of considering metastasis. MRI showed the lesion size was 15 × 10 milimeters, in the region corresponding to right auricular helix. It was hypointense on T1-weighted images and hyperintense on T2-weighted images. After ıntravenous injection of contrast agent; lesion was enhanced and demonstrated diffuse increase in thickness of right auricula (Figure 1). Described lesion has been surgically removed from the patient who had primary malignancy background. Histopathological assessment of the lesion demonstrated epidermal acanthosis, granulomatous dermal inflammation and dermal thinning; hence the diagnosis of chondrodermatitis nodularis chronica helicis is confirmed [1-4].
Chondrodermatitis nodularis chronica helicis (CNCH) is a benign inflammatory disorder, it is characterised with auriculer nodul. CNCH often occured on the auricular helix, less frequently on the auricular antihelix, it is characterised with painful nodul or nodules. CNCH is first described by Winkler, in 1915; for this reason also known as Winkler's disease. Although the pathological diagnosis is easy with it's specific histopathological findings, this pathology is less known by radiologists. In such cases, similar to our patient, the disease may be confused with metastasis especially in the differential diagnosis of patients with primary malignancy that arises from the skin. We described magnetic resonance imaging (MRI) findings of a 66-years-old man with painful tumor at helicis of right ear who have history of squamous cell cancer on the left temporal region skin [5,6].
Figure 1: Axial T1 weighted MRI of the right auricular helix (A) demonstrates hypointense nodular mass lesion. On axial T2 weighted MRI; (B) it appears as hyperintense nodular mass lesion. Contrast enhancement is not appreciated at contrast-enhanced T1-weighted imaging; (C) diffuse increase in thickness of right auricula was visible on all sequences.
Bard JW (1981) Chondrodermatitis nodularis chronica helicis. Dermatology 163: 376-384.
Munnoch DA, Herbert KJ, Morris AM (1996) Chondrodermatitis nodularis chronica hefcis et antihelicis. Br J Plast Surg 49: 473-476.
Santa Cruz DJ (1980) Chondrodermatitis nodularis helicis: a transepidermal perforating disorder. J Cutan Pathol 7: 70-76.
Goette DK (1980) Chondrodermatitis nodularis chronica helicis: a perforating necrobiotic granuloma. J Am Acad Dermatol 2: 148-154.
Oelzner S, Elsner P (2003) Bilateral chondrodermatitis nodularis chronica helicis on the free border of the helix in a woman. J Am Acad Dermatol 49: 720-722.
Taylor MB (1991) Chondrodermatitis Nodularis Chronica Helicis. J Dermatol Surg Oncol 17: 862-864.