原发性皮肤黏液癌复发

Recurrent primary mucinous carcinoma of the skin:a case report

报告1例术后复发的原发性皮肤黏液癌。患者男,55岁。左侧面部结节3年,术后病理诊断为黏液癌。手术切除后皮损又复发1年。系统检查未发现内脏肿瘤。皮肤科检查:左外眦下方见一直径1.2 cm的淡红色结节,表面毛细血管扩张,结节界限清析,表面光滑,触之质软,略有弹性,无明显触痛及压痛,与周围组织无粘连。皮损组织病理检查示瘤体位于真皮内,可见被纤维组织包绕分隔的黏液湖,黏液湖内见岛状瘤细胞团块。免疫组织化学病理:细胞角蛋白7(CK7)阳性;CK20、绒毛蛋白(villin)、甲状腺转录因子1(TTF1)、前列腺特异抗原(PSA)、S-100蛋白、p63蛋白、钙调蛋白(calponin)、平滑肌肌动蛋白(SMA)均阴性。诊断:原发性皮肤黏液癌术后复发。治疗:局部广泛切除肿瘤联合皮瓣修复。术后愈合良好,随访3年无复发。

A case of primary mucinous carcinoma of the skin with recurrence after excision is reported. A 55-year-old male presented with a recurrent nodule on the left face for 1 year. Past medical history was significant for a nodule on the left face for 3 years, which had been diagnosed as primary mucinous carcinoma of the skin by pathological evaluation and treated with surgical resection. Dermatological examination revealed a reddish nodule measured 1.2 cm in diameter under the left lateral canthus. The nodule was well-circumscribed with smooth surface and telangiectasia and was soft without tenderness to the touch. No visceral tumor was found by systematic examination. Histopathologic examination showed a dermal tumor consisting of islands of basaloid cells separated by fibrous septae, floating in large pools of mucin. On immunohistochemistry,the neoplastic cells were positive for CK-7 and were negative for CK20, villin, TTF1, PSA, S100, p63, calponin and SMA.The diagnosis of recurrent primary mucinous carcinoma of the skin was made, and extensive local resection combined with flap repair was performed. The patient had no evidence of recurrence during a close follow-up for 3 years.