皮肤小汗腺螺旋腺瘤恶变1例并文献复习

Malignant transformation in eccrine spiradenoma: a case report and literature review

对1例皮肤小汗腺螺旋腺瘤恶变进行观察,形态学分析及免疫组织化学染色,结合文献分析其临床病理特征。患者,女,58岁,发现左下腹部皮肤肿物30多年。B超探及一大小约2.1 cm×1.8 cm的囊壁回声结节,囊实性,界清,边界完整。镜下示肿瘤位于真皮深层,呈囊实性,大部分区域呈典型良性螺旋腺瘤形态,但肿瘤细胞核质比增高,核分裂象易见,局部发生恶性变。免疫组织化学方面,肌上皮的减少或丧失以及Ki-67的高表达有助于确诊。皮肤螺小汗腺旋腺瘤恶变罕见,熟悉其组织学特点有助于正确诊断。

One case of malignant transformation in eccrine spiradenoma was analyzed on image observation, morphological analysis with review of the literature. A 58-year-old female patient suffered from a cutaneous mass on her left lower abdominal wall for 30 years. Ultrasonography revealed a demarcated heterogeneous-echoic solid mass containing cystic change. It was encapsulated with a 2.1 cm × 1.8 cm nodule attached in the cystic wall. Histologically, the tumor was located in deep dermis. In its solid part, a classic benign spiradenoma was identified. The malignant transformation, however, was recognized in focal area. Those cancer cells were atypical and with high N/C ratio. Immunohistochemically, decrease or loss of myoepithelial and highly expression of Ki-67 were the key to diagnosis. Eccrine spiradenoma with malignant transformation is rare. Familiarity with its histologic characteristics is helpful to making correct diagnosis.