Gigantic cutaneous horn: A case report and review of literature

Abstract: Cutaneous horns are rare, keratinized protrusions that resemble animal horns. The prevalence and incidence of cutaneous horns are not well-documented, but they are more commonly found in individuals aged 60 to 80, particularly in sun-exposed areas. Older populations have a higher likelihood of these lesions being premalignant or malignant, with males exhibiting a greater incidence of such forms compared to females. We report a notable case of a giant cutaneous horn in a 75-year-old female patient, who presented with a painless, slowly growing lesion on the back of her head, measuring approximately 25 cm in height and was located on the occipital area. Imaging revealed a large soft tissue mass in the occipital area, alongside two trichilemmal cysts. Following complete excision and V-Y plasty, histopathological analysis confirmed a well-differentiated squamous cell carcinoma with keratin horn formation. The excision margins were clear, and the patient had a successful recovery with no recurrence after five years. This case highlights the critical need for a comprehensive evaluation of cutaneous horns, as they may contain malignant transformations and suggest underlying pathologies that needs careful assessment and intervention.