右下肢小汗腺螺旋腺癌1例报道并文献复习

目的:探讨小汗腺螺旋腺癌的诊断和治疗方法.方法:报道1例右下肢小汗腺螺旋腺癌,探讨小汗腺螺旋腺癌的诊治.结果:患者为67岁老年女性,因发现右下肢肿块进行性增大就诊,2015年6月4日手术切除病灶,术后病理确诊为小汗腺螺旋腺癌.患者术后全身PET/CT提示右髂血管旁及右侧腹股沟淋巴结转移,术后尝试“mFOLFOX”方案化疗.但患者分别于2015年8月31日及2015年12月23日因发现肿瘤局部复发而行减瘤手术.术后患者因体质弱,未再继续行抗肿瘤治疗,行最佳对症支持治疗,于2016年7月21日死亡.结论:小汗腺螺旋腺癌临床表现常缺乏特异性,需由组织病理确诊,大范围手术切除是其首选治疗方式,目前仍无公认的化放疗方法,预后极差,生存期短.

A case report of malignant eccrine spiradenoma and review of the literature

Objective:To explore the diagnosis and treatment of malignant eccrine spiradenoma.Methods:We reported a case of malignant eccrine spiradenoma,and reviewed literature about the diagnosis and treatment of malignant eccrine spiradenoma.Results:We reported a case of a 67-year-old woman,who found an enlarging nodule in her right lower limb and underwent surgical resection of the mass in June 2015,the postoperative pathology showed malignant eccrine spiradenoma.After local resection,multiple metastases to the right iliac artery and right inguinal lymph nodes were confirmed by postoperative positron emission tomography/computed tomography of the whole body.She agreed to a trial of chemotherapy of "mFOLFOX",but the patient had a tumor recurrence and did operation twice.After surgery,the patient did not have antitumor therapy due to physically weakness.She was given the best symptomatic and supportive treatment and died on July 21st,2016.Conclusion:The clinical manifestation of MES lacks the specificity,and MES should be confirmed by pathology,the first choice for treatment of MES is complete resection covering enough tumor-free margins.There is still no generally accepted chemoradiotherapy,the prognosis of MES is poor and it has short survival time.