A Pedunculated Giant Cutaneous Horn Variant Overlying Invasive Squamous Cell Carcinoma of the Scalp
Bibliographic record
Abstract
Giant cutaneous horns (GCH) present as isolated skin lesions with large corneous components of considerable morphologic variation. Despite their striking clinical appearance, prevalence statistics are unknown due to their rarity. Diagnosis of the underlying pathology is essential for appropriate management, as a significant proportion of cutaneous horns arise in the setting of a cutaneous malignancy [[ 1 ] [ 2 ]]. A morphological variant of a giant cutaneous horn was incidentally discovered on the posterior scalp of a 92-year-old Caucasian female during a hospital admission for a hemorrhagic stroke. The GCH measured 12 cm in straight length and 5.4 cm in base width. The entire lesion was supported by a highly unusual, mobile cutaneous stalk measuring 1.2 cm in length and 1.6 cm in width ([ Fig. 1A ]). The onset of growth of the lesion is unknown. The patient had an unremarkable prior medical history. An unenhanced computed tomography scan of the head showed an irregular soft tissue mass attached to the subcutaneous tissues of the posterior scalp without periosteal involvement. Calcifications were noted within the base of the lesion ([ Fig. 1B ]). The horn and stalk were excised under local anaesthesia with 0.5-cm margins, and the defect was closed primarily. A gross cross-section of the base of the CGH showed a hollow core surrounded by ridges of calcific debris and dense keratin ([ Fig. 2A ]). Histologic examination of the base showed an invasive squamous cell carcinoma with ulceration corresponding to grade 2 moderately differentiated tumor pathology ([ Fig. 2B ]). All surgical margins were negative for malignancy. Fig. 1 (A) Pedunculated giant cutaneous horn based at the occipital scalp. (B) Coronal 2-dimensional computed tomography image showing the lobular giant cutaneous horns base with calcifications attached to subcutaneous tissue by a 1.2-cm stalk. Fig. 2 (A) Cross-section of the giant cutaneous horns (GCH) showing hollowing of conical component with surrounding parakeratosis, calcific debris and keratin. Ruler markings in centimeters. (B) H&E stained section (×100) of the GCH base with moderately differentiated squamous cell A B carcinoma. We thank Dr. Janet Malowany, MD FRCP(C) in the Department of Laboratory Medicine at St. Joseph's Health Centre, Toronto, Ontario, Canada for reviewing the histopathology included in this case report. Publication History Received: 16 April 2016 Accepted: 06 September 2016 Article published online: 20 April 2022 © 2016. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/) Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".