生殖器部位基底细胞癌11例临床和病理分析

Clinicopathological analysis of 11 cases of genital basal cell carcinoma

目的:分析生殖器部位基底细胞癌的临床及组织病理特点。方法:回顾第四军医大学西京皮肤医院于2007年4月—2015年4月经组织病理确诊的11例生殖器部位基底细胞癌的临床表现和组织病理特点。结果:11例患者中,男7例,女4例,平均发病年龄57岁。其中8例在术前临床诊断中误诊。11例皮损分别表现为4例红斑溃疡,边缘隆起;3例黑色斑块(其中1例呈疣状增生);2例黑色丘疹;1例黑色斑片;1例黑色结节。组织病理表现为真皮中的基底样细胞团块,周边胞核呈栅栏状排列,肿瘤周围可见裂隙。临床皮损的宽度与肿瘤浸润深度无直线相关性。除2例失访外,1例肿瘤行局部扩大切除半年后复发,余患者经局部扩大切除随访至今未出现肿瘤复发、淋巴结或远处转移。结论:生殖器部位基底细胞癌患者多为中老年人,临床少见,容易误诊。对疑似病例均应行局部扩大切除及组织病理学检查。肿瘤大小对判断手术切口深度无指导意义。

Objective： To analyze the clinical and pathological features of genital basal cell carcinoma. Methods： We retro- spectively analyzed clinical manifestation and pathological features of genital basal cell carcinoma in 11 patients from our de- partment from April 2007 to April 2015. The diagnosis of basal cell carcinoma was confirmed by histopathology. Results： There were seven males and four females with average age of 57 years. 8 cases were misdiagnosed prior to surgery. 4 patients had ulcerated erythematous plaque with elevated borders, 3 patients were with pigmented plaque （one verrucous hyperplasia） and two with pigmented papule. Pigmented patch and nodule were one each. Histopathology showed dermal tumor masses composed of basaloid cells, peripheral palisading of the tumor nuclei and cleft formation. There was no linear correlation between tumor size and the depth of invasion. Following extensive local excision, two patients were lost to follow up, one had recurrence after six months, and the rest had no recurrence or any metastasis. Conclusion： Genital basal cell carcinoma is rare and can be easily misdiagnosed. It often occurs in the middle and aged. Both extensive local excision and histopathological examination are necessary when basal cell carcinoma is suspected. The depth of surgery cannot be based on the tumor size.