Skin carcinomas in patients with chronic lymphocytic leukaemia [Carcinomi cutanei in corso di leucemia linfatica cronica]

Among the secondary malignant neoplasms developed in patients with chronic lymphocytic leukaemia (CLL), skin carcinomas are considered particularly important for their incidence and their biological behaviour, sometimes very aggressive, with frequent relapses and multiple lesions. To evaluate the incidence of skin carcinomas in patients with CLL we selected all the subjects with skin carcinomas from the group of 1010 patients affected by CLL with B cells, followed-up from January 1992 to January 2003, in the Ambulatory of the Department of Hematology of University of Rome "La Sapienza" and sent to consultation to the Ambulatory of Oncologic Dermatology. We observed 27 subjects affected by 35 skin carcinomas: 19 basal cell carcinomas (BCC) (54.289%), 10 squamous cell carcinomas (SCC) (28.57%), 4 metatypic carcinomas (11.42%), 2 Bowen's tumors (5.71%). In 7 patients there were multiple tumors (25.92%). The immunohistochemical study evidenced peritumoral infiltrates in more than 50% of the cases, composed mostly by B lymphocytes. According to these data we can confirm that skin carcinomas in subjects with CLL are not rare and may be multiple and/or invasive even if prognosis is generally related to the course of haematological disease. In fact during follow-up 4 out of these 27 patients died: three for progression of haematological disease and one for lung carcinoma.