瘢痕继发小汗腺汗孔癌1例

A Case of Eccrine Porocarcinoma Developed on Scar

患者女,72岁。右耳前面部皮肤出现肿物伴渗血50天。60年前右耳前肿物处曾有外伤后破溃史,愈后留有瘢痕(7.0cm×5.0cm),50天前该处皮肤被耳环钩破,后结痂,但痂皮常被擦破,可见出血。皮肤科情况:瘢痕中间可见一圆柱状蚕豆大斑块,呈暗红色,基底部有红晕,表面凹凸不平,周边有渗血,结黄痂和血痂。皮损组织病理示:肿瘤细胞从表皮向真皮浸润性生长,可见细胞异型性、病理性核分裂相,部分区域可见导管样结构。免疫组化染色示导管样结构EMA和CEA阳性。诊断:瘢痕继发小汗腺汗孔癌。

Objective A 72-year-old female presented with a solitary tumor on her face anterior her right ear for 50 days. The low part of her right face, which was broken by earrings 50 days ago and scabbed, after that the crust was often rubbed into broken, remained a scar after having had trauma sixty years ago. Dermatologic examination revealed that there was a red, broadbean size plaque,which was column like with uneven surface covered with yellow and blood crust, in the middle of the superficial scar which was 7.0cm × 5.0cm centimeter on the low part of right face. The basement of the tumor was surrounded with red areola. Histopathological examination showed an invasive growth of the tumor cells from the epidermis into dermis. Atypical tumor cells and abnormal mitotic figure can be seen. Ductlike structures can be seen in focal area. Immunohistochemical staining showed the tumor cells in the duct-like structures were positive for EMA and CEA.