鳞状细胞癌放疗后非典型性纤维黄瘤1例

患者男,78岁。18年前患者左面颊出现黄豆大肿物,逐渐增大、破溃,针刺细胞学检查诊断为鳞状细胞癌。放疗后,皮损消退。3个月前,原损害处再次出现黄豆大结节,反复破溃。病理检查为非典型性纤维黄瘤。手术切除,术后放疗,随访半年无复发、无转移。     

巨大复发性化脓性肉芽肿一例

患者男。４８岁。因左腕部肿物切除后复发４０余天,于１９９３年１２月１６日由显微外科转入我科。５个月前,左腕刺伤后,局部出现一红色肿物,无痛痒,渐增至花生米大,在当地医院切除。术后１周,切口处出现数个增生物,外观与术前肿物相同,生长迅速并融合。２月前,来我院外科就诊,肿物增至８ｃｍ×６ｃｍ,呈菜花样,有破溃（图１）。拟诊鳞癌,收入显微外科,行左腕包块扩大切除加皮瓣游离移植术。术后９天,缝合处发现多个鲜红色新生物。已切除肿物病理报告：鳞状上皮呈乳头瘤样增生及溃疡形成,可见菌丝及孢子。疑诊真菌性肉芽肿…     

肺小细胞癌并头皮转移1例

<正>1临床资料患者男,60岁。后枕部肿物1个月,手术切除后复发10d。1个月前无明显诱因后枕部出现一肿物,呈进行性增长,无破溃、疼痛;3周前于当地行手术切除,10d前于原手术部位肿物复发,渐增大至核桃大小。自发病以来,精神逐渐萎靡不振,无发热及其他不适。既往体健,否认有呼吸道及肺部疾病。吸烟40年余,家族史无特殊。查体:精神欠佳,系统检查未见明显异常。皮肤科情况:后枕部可见1个直径约4cm紫红色肿物,表     

小汗腺螺旋腺癌1例

报告1例小汗腺螺旋腺癌。患者男,51岁,因"下颌肿物10余年,切除后复发5年,伴疼痛"就诊。皮肤专科检查:右下颌可见一约2 cm×2 cm大的淡红色皮下结节,境界清楚,质硬,表面皮损无破溃、渗出,腋下等浅表淋巴结未触及。皮损组织病理检查可见表皮结构正常,真皮内可见境界清楚、嗜碱性的瘤体,可见良恶性相互移行;肿瘤细胞核分裂像多见,胞浆丰富。免疫组织化学示:EMA过表达集中于癌变区域以及Ki-67高表达。诊断为小汗腺螺旋腺癌,局麻下行肿物切除术,术后病人失访。     

Mohs显微描记手术治疗小汗腺汗孔癌一例

患者,男,56岁。左颞部肿物4年余,切除后复发半年。组织病理示：真皮内肿瘤团块,部分伴中央片状坏死。免疫组化示：肿瘤细胞CK5/6阳性,瘤团坏死周边瘤细胞EMA阳性。诊断为小汗腺汗孔癌。Mohs显微手术切除及全厚皮片移植术后恢复良好,随访18个月无复发。     

手术治疗复发性非典型性纤维组织细胞瘤1例

患者女,19岁,左前臂出现无痛性肿物1年。皮肤科情况:左前臂单发约1 cm×0.9 cm大小、质地中等硬度的皮肤肿物,与周围组织界限不清,表面无破溃及触痛。皮损组织病理示:肿瘤细胞呈席纹状排列、有病理性核分裂象及泡沫细胞,免疫组织化学CD34染色肿瘤细胞部分阳性,诊断为非典型性纤维组织细胞瘤。常规手术切除后2个月复发,再次扩大切除后,随访21个月未见复发。     

血管淋巴样增生伴嗜酸性粒细胞增多1例

患者女,48岁。7年前无明显诱因左额顶部和耳周出现皮损,初期似小米粒大,逐渐增大、增多。曾用青霉素960万U/d静脉滴注,口服地塞米松5.25mg/d治疗无效,在外院行局部手术切除。术后组织病理诊断为“木树病”。1年后,原切除部位皮损复发,并出现多发性、融合性皮下结节,时常疼痛、瘙痒,破溃后流血不止。     

多发性小汗腺血管瘤样错构瘤一例

报道1例多发性小汗腺血管瘤样错构瘤.小汗腺血管瘤样错构瘤是一种少见的皮肤肿瘤.病理表现为增多的小汗腺结构和大量血管成分.本例患儿8岁,左前臂多发性皮下结节伴疼痛4年,近1年局部出现多汗、多毛.经组织病理检查结合临床表现,诊断为小汗腺血管瘤样错构瘤.浅层x线照射后效果不明显,后进行分次手术切除,疗效较佳.提示治疗小汗腺血管错构瘤选择适当的手术方案是可行的.     

微囊肿性附属器癌

患者男, 34岁。因左颞部皮损 20年,术后多次复发于 1998年 6月 29日就诊。 20年前发现左颞部长一黄豆粒大小肿物,正常肤色,无痛痒,生长缓慢。 1996年肿物生长加速并破溃。 1997年 6月在当地行肿物切除,术后 2个月肿物复发并逐渐增大而来我院。 体检： 生长发育正常。左颞部见一长约 2.5 cm的手术瘢痕,灰白色,无毛发,中央部见一 2.0 cm× 2.0 cm× 1.0 cm结节,质较硬,活动欠佳。左耳后触及一长径约 0.8 cm的淋巴结。将肿物连同瘢痕一并切除后送病理检查,真皮及皮下组织内见一 2.0 cm× 2.0 cm× 1.0 cm边界欠清的肿物,灰白色杂…     

食管癌皮肤转移1例

1 病历摘要 患者男,53岁.因食管癌术后齿龈肿物和左足第4趾肿物10个月于2010年7月28日来我科诊治.患者9个月前因吞咽困难诊断为食管癌,于外院全麻下行左颈、右胸、腹正中三切口将食管大部切除、胃代食管左颈部吻合术,术后组织病理检查:食管髓质型低分化鳞状细胞癌(简称鳞癌),术后吞咽困难消失,但出现声音嘶哑.住院期间发现右上牙龈出现肿物,约黄豆大,破溃出血,无明显疼痛,组织病理检查:右上齿龈肿物为高分化鳞癌.同时发现左足第4趾肿物,趾端肿物膨大呈车轮状,伴皮肤过度角化,表面皮肤糜烂,质硬,无溃疡,未治疗.术后1个月开始行紫杉醇与顺铂联合化疗方案,每周化疗6次,同时行放疗32次,共59 Gy.经上述放、化疗右上牙龈肿物渐缩小,左足第4趾肿物未见明显变化.     

A Case of Eccrine Porocarcinoma: Usefulness of Immunostain for S-100 Protein in the Diagnoses of Recurrent and Metastatic Dedifferentiated Lesions

Eccrine porocarcinoma is a rare malignant tumor. Immunostain for S-100 protein, in addition to epithelial membrane antigen (EMA) and carcinoembryonic antigen (CEA), is described to be useful in the diagnosis. Herein, we report a case of eccrine porocarcinoma with immunostain for S-100 protein which was useful in diagnoses of recurrent and metastatic lesions. The primary lesion in the left inguinal region was excised, but it recurred on the same site 14 months after the resection. The recurrent lesion showed epithelioid melanocytic findings. Three months later, metastasis to the lungs was found. Since these recurrent and metastatic lesions were dedifferentiated, typical histologic findings of eccrine porocarcinoma disappeared in biopsied specimens. Nevertheless, scattered immunoreactive cells for S-100 protein were maintained in these dedifferentiated lesions. S-100 protein positive cells could be an aid to diagnose, even if histologic findings of recurrent and metastatic lesions have changed by dedifferentiation.     

A Case of Eccrine Poromatosis in a Patient with a History of Chemotherapy Due to Stomach Cancer

An eccrine poroma (EP) is a benign adnexal tumor that typically presents as a single lesion. Eccrine poromatosis defined as multiple EPs is an uncommon presentation. A 54-year-old male had undergone operation for stomach cancer 10 years prior and insisted that he had also taken adjuvant chemotherapy. The patient presented with six reddish papules and nodules scattered on the trunk and extremities for 3 years. The histopathologic findings from all six lesions were consistent with EP. No local recurrence was observed after complete removal through punch biopsies. We report a rare case of eccrine poromatosis in the patient with gastric cancer, suspected of being caused by chemotherapy.     

额部隆突性皮肤纤维肉瘤一例

患者男,56岁,因左前额部肿块1年余入院.患者20年前左前额部因黄豆大小肿块,曾行切除术.1年前肿块复发并增大,无明显自觉症状来我院就诊.皮肤科检查:左前额部见3 cm×2 cm×1 cm大小的肿块,呈淡红色半球形隆起于皮面,表面皮肤光滑,紧张,质地较硬,与皮肤粘连,但与深筋膜无明显粘连,无触压痛.肿块周围可见明显凹陷区.皮损组织病理:真皮中下层及脂肪内可见大量梭形细胞增生,细胞轻度异形,呈编织状排列.免疫组化染色:CD34(+),波形蛋白(+),CK(-),S-100(-),上皮膜抗原(-).诊断为隆突性皮肤纤维肉瘤.切除肿瘤并行游离全厚皮片移植,术后皮片生长良好,效果满意.     

复发性恶性纤维组织细胞瘤

报告1例切除14年后复发的恶性纤维组织细胞瘤。患者男，62岁。14年前行右胫前恶性纤维组织细胞瘤切除术，术后恢复良好。3个月前右胫前原手术部位又出现一肿块，逐渐增大，3d前肿块表面皮肤破溃，无明显自觉症状。肿块组织病理检查：肿瘤细胞排列呈梭形或星形，可见核分裂相及核瘤巨细胞，肿瘤细胞位于黏液样基质中，间质血管丰富，出血明显。     

Eccrine Poroma on the Face: An Atypical Presentation

An eccrine poroma is a solitary tumor arising from the eccrine duct epithelium in the epidermis. The lesions commonly occur on the sole of the foot, the hands, and occasionally on the nose, eyelids, neck, and chest. We report a patient who presented with a slow-growing nodular lesion over her left cheek, prompting a diagnosis of basal cell carcinoma or keratoacanthoma. Biopsy from the nodule revealed a well-defined epidermal tumor with uniform small cuboidal cells with rounded deeply basophilic nuclei, few narrow ductal lumina, and occasional cystic spaces confirming the diagnosis of an eccrine poroma.     

Malignant eccrine spiradenoma (spiradenocarcinoma): a clinicopathologic study of 12 cases

Malignant eccrine spiradenoma is a very rare tumor. The clinicopathologic features of 12 cases are reported herein. Six patients were men, six were women, and the average patient age was 62 years. Seven tumors were located on the trunk, three on the extremities, and two in the head and neck region. All tumors were large (average size-7.5 cm). Lesions had been present from 7 months to 30 years before surgical removal. In all cases, continuity between benign eccrine spiradenoma and areas with malignant change was observed. Malignancy was evidenced by increased mitotic rate, necrosis, nuclear atypia, pleomorphism, and hyperchromasia, loss of nested and trabecular growth patterns, and absence of a dual cell population. In most cases (8 of 12), the malignant component comprised the bulk of the lesion. Two distinctive histologic patterns were observed. Five of 12 tumors exhibited abrupt transition between a benign eccrine spiradenoma and a high-grade carcinoma component. The others lacked a clear-cut transition between benign and malignant components and were diagnostically challenging. Diagnosis in such cases was established based on the loss of two cell populations, increased nuclear to cytoplasmic ratio, hyperchromasia, and marked mitotic activity. Two tumors showed focal squamous differentiation. Five of seven patients on whom there was follow-up information were free of disease (average duration of follow-up = 3.4 years). One patient developed metastases to local lymph nodes 5 years after the primary tumor was resected. This patient had no evidence of disease 16 months after resection of her lymph node metastases.     

Eccrine porocarcinoma, tricholemmal carcinoma and multiple squamous cell carcinomas in a single patient.

A 75-year old woman without remarkable medical history presented with a large eccrine porocarcinoma of the trabelucar type located on her leg. This tumor was associated with two invasive squamous cell carcinomas of the legs, two Bowen's diseases of her thigh and arm and multiple actinic keratoses of the face. Despite major surgery, local recurrence of the porocarcinoma was observed 6 months later. During the 3-year follow-up after a second surgical intervention, this lesion did not reccur, but the patient developed a rapidly enlarging ulcerated tumor of the forehead which proved to be tricholemmal carcinoma. Although no carcinogenetic factor or familial history of multiple neoplasms could be evidenced, the occurrence of multiple tumors of various histogenesis over a 1 year period of time is unlikely to be fortuitous. Such an association of rare adnexal neoplasms has not yet been described.     

Dermatofibrosarcoma protuberans association with nuchal-type fibroma

BACKGROUND: Dermatofibrosarcoma protuberans (DFSP) is a hypercellular, storiform, CD34-positive low-grade sarcoma with honeycomb entrapment of fat, which typically involves the trunk and extremities. Nuchal-type fibroma (NTF ) is a paucicellular, CD34-positive fibrous tumor with fat entrapment, which may occur in both nuchal and extranuchal locations and in association with Gardner syndrome. METHODS: We report the association of DFSP with NTF in a 43-year-old male with no personal or family history of Gardner syndrome. RESULTS: The patient had a past history of a DFSP removed from his back, which recurred 2 years later and was re-excised. Additionally, the patient had a typical NTF, in the posterior neck, removed at the same time. Histopathologic examination of the recurrent back lesion demonstrated a composite lesion with typical appearances of DFSP, centrally, blending into an NTF-like appearance, peripherally. Both components expressed CD34 and CD99, and lacked elastin. A review of the microscopic slides of the patient's previously excised DFSP revealed an identical lesion with surrounding NTF-like areas. CONCLUSION: While an association between NTF and fibromatosis has recently been reported, this is to our knowledge the first report of an association between NTF and DFSP. The morphologic findings suggest that there may be a continuum between these two CD34-positive lesions that have a tendency to infiltrate adipose tissue and recur.     

Cemento-ossifying fibroma of the left mandible: A case report

Ossifying fibroma is a type of benign fibro-osseous lesion. Most lesions affect the mandible region, particularly the molar and pre-molar areas. It predominantly affects females between the second to fourth decades of life. Larger ossifying fibroma tumors require more extensive resection. CASE SUMMARYA 39-year-old female complained of occasional pain and tumor enlargement on her left jaw for the 3 years prior to presentation. Intraoral examination revealed a firm swelling on her left lower gum. Extraoral examination revealed swelling on the left mandible body with no erythema and superficial ulcer. Computed tomography scan revealed a circular-shaped lesion on the patient’s left mandible body with a well-defined radiolucent border, sized 3.2 cm × 2.8 cm × 0.9 cm. The tumor was removed by marginal mandibulectomy. Biopsy from the resected tumor suggested cemento-ossifying fibroma (COF). CONCLUSIONCOF is often unnoticed, but this slow-growing tumor can cause significant symptoms regarding its distortion into adjacent structures.     

原发性皮肤中心母细胞淋巴瘤1例

报告１例原发性皮肤中心母细胞淋巴瘤。患者，男，９２岁。右小腿被蚊虫叮咬后出现肿块１年半，增多、扩大、破溃伴左小中块２个月。血常规、Ｘ光胸片、腹部Ｂ超、骨髓检查未划常。病检示肿瘤细胞形态似中心母细胞，免疫组化证实瘤细胞的Ｂ细胞性。ＥＢＥＲ原位杂交末检测到ＥＢ病毒。患者未作放化疗，９个月后死亡。