頁籤選單縮合
題 名 | Recurrent Eccrine Syringomatous Carcinoma in the First Web Space of the Hand: A Rare Case=手部虎口復發性汗腺癌--罕見病例報告 |
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作 者 | 朱純慧; 陳俊嘉; 李玉雲; 謝式洲; | 書刊名 | 臺灣整形外科醫學會雜誌 |
卷 期 | 19:3 2010.09[民99.09] |
頁 次 | 頁237-243 |
分類號 | 415.656 |
關鍵詞 | 汗腺癌; 前臂筋膜皮瓣; Eccrine syringomatous carcinoma; Radial forearm flap; |
語 文 | 英文(English) |
中文摘要 | 背景:汗腺癌在皮膚附屬器中是相當罕見的惡性腫瘤,在臨床診斷及組織學鑑別上也非常困難。由於其具有快速增長與遠處轉移的潛在危機,儘早的診斷能爭取更多時間治療。這種少見的汗管癌好發於頭頸部,文獻上報告只有五例發生於頭頸之外的區域:包括臀部、肛門口附近、手部、以及腋下。我們報告另一個病例發生在手部的虎口區域。目標:對於此種罕見的汗腺癌能夠在臨床及組織學上早期診斷,並且針對此特殊位置在腫瘤大範圍切除之後,給予適當的重建方法。材料與方式:一個62歲的婦女自2004年起在左手虎口部位,於外院診斷爲乳頭腺癌。她接受多次腫瘤切除與植皮手術,不幸的是,在2006年之前,仍然腫瘤復發兩次。第三次復發發生於2006年12月,她於成大醫院再度接受皮膚切片,組織學報告顯示診斷爲罕見的復發性汗腺癌。因此,我們於2007年1月大範圍切除腫瘤之後,同時以帶橈側血管遠端血循前臂筋膜皮瓣成功的重建虎口。結果:無皮瓣部分或者完全壞死,也無供皮瓣區的相關併發症。在2年半的追蹤之中,也無腫瘤的復發,同時手部功能及外觀也非常的好。結論:經由此罕見案例,我們提供了極具經驗性的病理鑑別,對於早期診斷有很大的幫助。早期的疏忽診斷常會造成不適當的治療計畫,會使得腫瘤變得更侵犯性、甚至造成遠端轉移。 |
英文摘要 | Background: Carcinoma of the sweat glands of the hand is an extremely rare dermal neoplasm that is difficult to clinically and histologically diagnose. However, because of its potential for rapid growth and metastasis, early recognition may allow more timely treatment. Only five cases of this rare adnexal tumor have been reported outside the head and neck area: on the buttock, perianal skin, hand, and axilla. We present a case of eccrine syringomatous carcinoma in the first web space of the hand. Aim and Objectives: To describe the early diagnosis of a rare type of malignant skin tumor using clinical and histological analyses, and to describe optimal web space reconstruction after wide excision of tumor. Materials and Methods: A 62-year-old woman, who had been treated elsewhere with a wide excision of the tumor and full-thickness skin graft repair for a left-hand first web space papillary carcinoma in 2004, presented with a third recurrence of her tumor in December 2006. A skin biopsy showed recurrent eccrine syringomatous carcinoma. A wide excision of the tumor with pedicled reverse radial forearm flap reconstruction was done in January 2007. Results: There was no necrosis on the flap, no donor site comorbidity, and no tumor recurrence at a 30-month follow-up. Good functional results were also obtained. Conclusion: Eccrine syringomatous carcinoma is an exceedingly rare cutaneous tumor that requires an experienced pathologist for an accurate diagnosis. An initially incorrect diagnosis may lead to the wrong operative plan, which may cause this invasive skin tumor to locally recur or even metastasize. |
本系統中英文摘要資訊取自各篇刊載內容。