颞部巨大溃疡性外毛根鞘癌1例

Huge Ulcer in Tempus of Tricholemmal Carcinoma: A Case Report

患者女,76岁。右颞部溃疡逐渐增大5年,加重2个月。皮损表现为右颞部一7cm×5cm大小溃疡,边界清楚,呈堤状隆起,表面伴脓血性分泌物,右耳后一2cm×2cm暗红色肿物。皮损组织病理示:表皮大致正常,真皮浅层见大片肿瘤细胞团块,呈分叶状分布,未与表皮相连,团块边缘肿瘤细胞呈栅栏状排列,团块中央肿瘤细胞多由透明细胞组成,伴有均质性角化,部分瘤细胞有显著的异型性和核分裂象。诊断:外毛根鞘癌。给予一个疗程的放射治疗后,患者失访。

A 76-year-old female presented with ulcer which was gradually enlarging in right tempus for 5 years ,and the lesion aggravated for 2 months. Physical examination showed 7cm x 5cm ulcer in right tempus of which the boundary was clear and with hunched like dike,covered with purulence and blood like secreta on it. A 2cm x2cm dark red neo- plasm was behind the right ear. Histopathology examination revealed that epidermis was almost normal;tumour cells arranged in groups and lobulated in corium layer. The tumour groups were not connected with the epidermis. The tumour cells around the group were arraied like barrier. The cells in the center of the group were consisted of hya- line cells,which had homogeneous cornification. Some tumour cells were remarkable heteromorphic with nuclear di- vision. The diagn,sis of tricholemmal carcinoma was made. After a course treatment of radiotherapy, the patient was lost to follow-up.