头皮血管肉瘤术后腮腺区转移2例

Two cases of metastasis in parotid region after surgery of scalp angiosarcoma

1病例报告例1,男,78岁,以"发现左耳后肿物2个月"于2017年9月13日入院。患者1年前因头皮血管肉瘤先后于我院骨科行头皮肿物扩大切除术及肌皮瓣移植修复术。术后病理报告为血管肉瘤,各切缘阴性;术后未行辅助治疗。2个月前无意中发现左侧耳后肿物,直径约2.0 cm,于门诊行活检,病理回报:皮肤及皮下组织,上皮脚下延、融合,真皮层可见异型细胞呈巢团状或条索状浸润,细胞大小不一,胞质丰富、上皮样,胞质透明或略嗜酸,核质粗糙,可见核仁,核分裂相散在可见,另见小块游离肿瘤组织。

Angiosarcoma of the scalp is an aggressive tumor with a high rate of local recurrence and distant metastasis.We present two cases of metastasis in parotid region at the time of one year after radical surgery of scalp angiosarcoma.It is suggested that regional lymph nodes should be treated more aggressively at the first treatment,which may achieve better results or,at least,prolong the time to local recurrence and distant metastasis.