汗管样小汗腺癌

Syringoid eccrine carcinoma:a case report

报告1例汗管样小汗腺癌。患者女,56岁。左外耳部浸润性斑块伴疼痛10年。皮肤科检查见左外耳郭浸润性肤色斑块,总面积达4 cm×3 cm,中央偏红,表面平滑,无破溃,与皮肤粘连,质硬固定,伴触痛。皮损组织病理检查:真皮中下部及皮下组织间多数基底样瘤细胞团块,瘤细胞形成巢状、条索状或蝌蚪样肿瘤团块,伴有大量管腔及囊腔样结构形成,纤维结缔组织明显增生,与瘤细胞间形成明显的主间质分离。未见角质囊肿及筛状结构形成。免疫组化染色示:上皮膜抗原(EMA)、癌胚抗原(CEA)、细胞角蛋白CAM5.2、细胞角蛋白(CK)7和CK5/6阳性,S-100蛋白阳性,囊泡病液体蛋白(GCDFP)-15、CK20、甲状腺转录因子(TTF)-1均阴性。该病例被诊断为汗管样小汗腺癌。

A case of syringoid eccrine carcinoma is reported. A 56-year-old woman presented a painful, skin-colored plaque on the left ear with a size of 4 cm × 3 cm for 10 years. The lesion was firm, smooth, tender, and fixed to the underly- ing tissue, without ulceration. Histopathology revealed clusters of basaloid tumor cells in the middle and lower dermis and subcutaneous adipose tissue, arranged in cords, nests and tadpole-like form, with tubulocystic formation and fibrous stroma proliferation, and separated from the tumor cells. Either keratinous cyst or sieve-like structure was not seen. Immunohisto- chemistry study showed positive staining for epithelial membrane antigen （EMA）, careinoembryonic antigen （CEA）, cytokeratin （CK）5.2,CK7,CK5/6 and S-100, and negative staining for thyroid transcription faetor-l（TTF-1）, CK20 and gross cystic disease fluid protein 15 （GCDFP 15）. The diagnosis was made as syringoid eccrine carcinoma.