頁籤選單縮合
題 名 | Merkel Cell Carcinoma--Cases Analysis and the Literature Review=梅克爾細胞癌--病例分析與文獻回顧 |
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作 者 | 陳承謙; 馬旭; 林進德; 廖文傑; 劉士豪; 葉發來; | 書刊名 | 臺灣整形外科醫學會雜誌 |
卷 期 | 21:1 2012.03[民101.03] |
頁 次 | 頁16-24 |
分類號 | 415.78 |
關鍵詞 | 梅克爾細胞癌; 皮膚惡性腫瘤; Merkel cell carcinoma; |
語 文 | 英文(English) |
中文摘要 | 背景:梅克爾細胞癌,於1972年首先由Toker所描述,是一種從皮膚神經內分泌細胞而來比較罕見且侵襲性的皮膚惡性腫瘤。它也被稱為小梁癌,原發性皮膚神經內分泌癌和Toker腫瘤。它往往表現為無症狀,於太陽暴露的皮膚上快速增長的結節,主要集中在頭部和頸部,接下來為四肢及軀幹。梅克爾細胞癌好發生在老年人且男性居多。但由於病例數有限導致病因所知甚少。目的及目標:本研究的目的是將本院治療經驗與文獻上他人的經驗作比較與分析。材料和方法:從1995年到2010年,共7例患者確診為梅克爾細胞癌於台北榮總接受治療。我們針對治療和預後進行回顧性評估。結果:所有參加這項研究的患者為男性,只有一個病人年紀小於60歲。四個病患腫瘤位於下肢而三個病患腫瘤位於軀幹。所有患者皆接受外科腫瘤切除並分別以局部皮瓣,皮膚移植或直接縫合進行重建。初步治療後,共有5例復發;其中三例為局部復發而兩例為淋巴結轉移。結論:梅克爾細胞癌是一種罕見,侵襲性且致命的皮膚惡性腫瘤。白人人口的發病率一直穩定的上升,但於亞洲患者只有少數的病歷被報告。雖然因為缺乏隨機且前瞻性試驗導致治療尚未標準化,大多數研究支持多模式療法,包括原發腫瘤廣泛切除,前哨淋巴結切片以評估淋巴結轉移狀態,輔助放射治療以降低局部及區域復發的風險,以及使用全身性化學治療於轉移性梅克爾細胞癌或無法接受手術的病患。由於病例數只有七人,仍需進一步研究以確定最佳的治療和準確的預後。 |
英文摘要 | Background:Merkel cell carcinoma (MCC), first described by Toker in 1972, is a relatively rare and aggressive cutaneous malignancy derived from the cutaneous neuroendocrine cells. It has also been called as trabecular carcinoma, primary neuroendocrine carcinoma of the skin, and the Toker tumor. It often presents as an asymptomatic, rapidly growing nodule on sun-exposed skin, primarily on the head and neck, followed by the extremities and trunk. MCC occurs significantly in elderly individuals with male predominance. But little is known about the etiologic causes because of limited case numbers.Aim and objectives:The aim of this study is to compare our experience with others in the literature review.Materials and methods:From 1995 to 2010, seven patients diagnosed as Merkel cell carcinoma were treated in VGH-TPE. The treatment and prognosis were evaluated retrospectively.Results:All the 7 patients enrolled in this study were male and only one patient younger than 60 years of age. The seven tumors located on lower extremities in four cases and three on trunk. All patients received surgical excision and reconstruction with local flap, skin graft or primary closure. After initial treatment, there were 5 cases of recurrences with 3 local recurrence and 2 nodal metastasis.Conclusion:MCC is a rare, aggressive and fatal cutaneous malignancy. The incidence has been rising steadily in Caucasian population, but few cases have been reported in Asian patients. Although the treatment of MCC was not standardized owing to the lack of a randomized and prospective trial, most studies support a multimodality approach, including wide surgical excision of primary tumor with clear margins, sentinel lymph node biopsy to evaluate the pathologic nodal status, adjuvant radiotherapy to lower the risk of local and regional recurrence, and systemic chemotherapy in the treatment of metastatic MCC or inoperable disease. Because the number of patients was only 7, further investigation is necessary to determine the optimal management accurate prognosis. |
本系統中英文摘要資訊取自各篇刊載內容。