女性外阴皮肤腺癌1例

Adenocarcinoma of Vulvar Skin in Woman:A Case Report

患者女,54岁,下腹、外阴丘疹、溃疡伴疼痛1个月。皮肤科情况:下腹和外阴可见丘疹和溃疡,左侧尤重。患者2年前因“宫颈癌”于院外手术。外阴丘疹、溃疡组织病理示:呈腺样或筛状排列的肿瘤细胞,瘤细胞核大、深染,胞浆丰富,异型性明显,间质纤维结缔组织增生伴有炎细胞浸润。免疫组织化学染色示:P16(+)、Ki-67(约20%+)、CAM(+)、CEA(+)、EMA(+)、PCK(+),PR(-)、ER(-)、GCDFP-15(-)、AR(-)、GATA-3(-)、CK5/6(-)、P63(-)。最终诊断为外阴皮肤腺癌。患者及家属放弃治疗,2个月后随访患者死亡。

A 54-year-old female presented with papules, ulcers on her lower abdomen and vulva for one month. Physical examination revealed papules and ulcers on the hypogastrium and vulva, especially on the left side. The patient underwent an operation for squamous cell carcinoma of the cervix 2 years ago. Histopathological examination of papules and ulcers in vulva showed that tumor cells were distributed in an adenoid or cribriform pattern, with large and hyperchromatic nuclei, abundant cytoplasm, and obvious atypia. The interstitium had fibrous connective tissue hyperplasia with inflammatory cells infiltration. In immunohistochemistry, infiltrated cells were positive for P16,Ki-67(20% positive),CAM,CEA,EMA,PCK and negative for PR,ER,GCDFP-15,AR,GATA-3,CK5/6,P63. Final diagnosis of the patient was vulvar cutaneous adenocarcinoma. The patient gave up treatment, and died two months later.