A 34-year-old woman with no morbid history presented with an asymptomatic lesion in the left thigh of 1 month of evolution.
Pyoderma was treated with multiple oral antibiotics without response.
On examination, the patient presented an erythematous 5 x 8 cm tumor with small ulcerations and erosions.
There was no exudate or grain output at compression.
In addition, he had two non-painful inguinal lymphadenopathies, approximately 1 cm ipsilateral. No other adenopathies or visceromegaly were observed.
A diagnosis of cutaneous lymphoma and an actinomycetoma was proposed, so serological tests, computed tomography (CT) with contrast of thorax, abdomen and pelvis (TAC-TAP) and multiple bacterial cultures were requested.
He had blood count, lactic dehydrogenase (LDH) and serum calcium within normal ranges, and HTLV-1 serology was negative.
The CAT-TAP showed only the ipsilateral lymph nodes clinically investigated.
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Histopathology showed an ulcerated dermal tumor composed of large lymphoid cells, with nuclear pleomorphism and atypical lymphoid mitosis.
In addition, there were abundant eosinophils.
Immunohistochemical study (IHC) showed positive reaction for CD30 in large cells and negative reaction for ALK-1 and CD25.
A bone marrow biopsy showed normal architecture and cellularity.
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All these elements led to the diagnosis of SCCGL.
Local radiotherapy (RT) was proposed, but when the patient returned to the clinic one month later, she presented a clear decrease in the size of the thigh lesion, so no treatment was initiated.
It was controlled every 4 months and at 24 months of follow-up it was in total regression.
