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題名 | Squamous Cell Carcinoma of the Scalp Arising from Chronic Discoid Lupus Erythematosus with Scarring Alopecia=發生於頭頂慢性盤狀紅斑性狼瘡結疤性禿髮部位的鱗狀細胞癌 |
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作者姓名(中文) | 胡楚松; 陳毓雯; 陳國熏; 鄭詩宗; | 書刊名 | 中華皮膚科醫學雜誌 |
卷期 | 25:2 2007.06[民96.06] |
頁次 | 頁165-170 |
分類號 | 415.78 |
關鍵詞 | 紅斑性狼瘡; 鱗狀細胞癌; Squamous cell carcinoma; Discoid lupus erythematosus; Scarring alopecia; |
語文 | 英文(English) |
中文摘要 | 由紅斑性狼瘡發生的腫瘤(包括基底細胞癌、鱗狀細胞癌和非典型纖維性黃色瘤等)比較罕見。我們在此報告一個在頭頂慢性盤狀紅斑性狼瘡結疤性禿髮部位長出鱗狀細胞癌的病例。為病人手術切除腫瘤後,發現是個侵犯很深幾乎接近頭骨的腫瘤。一系列的檢查(包括正子造影)發現有高機率頸部淋巴結轉移。雖然由紅斑性狼瘡發生的腫瘤比較罕見,可是還是要保持警覺。從慢性發炎疤痕部位長出的鱗狀細胞癌應被認為是一種高危險性腫瘤,有比較高的局部侵犯及轉移機率,因此需要作詳細檢查、較大範圍的切除與更密切的追蹤,必要時需作輔助性治療。另外正子造影是一種非侵入性及全身性的造影,可以發現局部淋巴結以及遠部器官轉移,對於高危險性鱗狀細胞癌病人的檢查有臨床幫助。 |
英文摘要 | Neoplasms have rarely been reported in lesions of lupus erythematosus (LE) and have included basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and atypical fibroxanthoma. We here report a case of SCC of the scalp arising from a patch of scarring alopecia secondary to chronic discoid lupus erythematosus (DLE). Surgical excision of the tumor with a 1cm margin was performed, showing a deeply invasive SCC extending to the deep fascia. A series of staging investigations were undertaken, including positron emission tomography (PET) scan, which revealed high risk of metastasis to the cervical lymph nodes. Although malignant transformation of chronic DLE lesions is uncommon, a high index of suspicion and need for continued surveillance is still warranted. A SCC arising from a chronic inflammatory scar such as seen in this case should be regarded as a high risk tumor with greater invasive and metastatic potential, and requires careful staging, greater excision margin, possible adjunctive treatments, and closer follow-up. In addition, since PET is a noninvasive and whole-body imaging modality that can detect both regional lymph node and distant organ metastases, it may be clinically useful in the staging of high-risk SCC patients. |
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