臀部化脓性汗腺炎继发巨大鳞状细胞癌1例

报告臀部化脓性汗腺炎继发巨大皮肤鳞状细胞癌1例。患者男,62岁,左臀部结节破溃伴痛40余年,外生性肿物20余年。皮肤科检查:左臀部覆盖黑色斑疹,质地较硬,边界尚清,表面凹凸不平,中央可见数个脓肿、窦道、瘘管及瘢痕,挤压后见淡黄色脓性分泌物流出,伴明显触痛、恶臭;左臀部下方近肛门侧见一约20 cm×20 cm大小的外生性肿块,呈菜花状生长,质地坚硬,活动性差,表面溃烂,可见较多脓性分泌物覆盖,触之易出血。直肠指诊:肛门松紧度可,肛内未触及肿块,指套不带血,腹股沟淋巴结无肿大。左侧臀部外生性肿块组织病理:肿瘤位于真皮内,部分与表皮相连,由鳞状上皮细胞团块组成,部分细胞胞浆透明,部分区域棘刺松解,异型性明显。免疫组织化学染色检查:P63(+),P40(+),CK5/6(+),CK7(-)。诊断:(左臀部)皮肤鳞状细胞癌、化脓性汗腺炎。治疗:手术切除。随访1年未见复发。

A patient with giant squamous cell carcinoma arising from hidradenitis suppurativa

We report a giant squamous cell carcinoma arising from hidradenitis suppurativa. A 62-year old man presented with ulceration and painful nodule on the left side of the buttock for over 40 years, and a neoplastic mass for more than 20 years. Dermatological examination showed that the left side of the buttock was covered by a demarcated black macule, with rough surface, abscesses, sinuses, fistulas, and scars. Compression induced foul smelling purulent secretion and tenderness. There was a cauliflower like exophytic tumor about 20 cm×20 cm in size near the anus on the left buttocks. The tumor was firm and ulcerative with poor mobility, covered with purulent secretions, and bleeding upon touch. No abnormalities were found by rectal touch and examination of the inguinal lymph nodes. Histopathology showed dermal tumor composed of clumps of squamous epithelial cells, partially connected to the epidermis, with transparent cytoplasm, atypia and acantholysis. Immunohistochemitical staining showed P63（+）, P40（+）, CK5/6（+）, CK7（-）. Diagnoses were skin squamous cell carcinoma and hidradenitis suppurativa. Surgical resection was given. No recurrence was found during the 1 year follow up.