增生性外毛根鞘瘤临床特点与治疗的相关分析

Analysis of clinical features and treatment of proliferating trichilemmal tumor

目的探究增生性外毛根鞘瘤(proliferating trichilemmal tumor,PTT)的临床特点、治疗方式与预后情况。方法收集自2010年1月至2022年1月,新疆医科大学第一附属医院整形科收治的23例患者的临床资料。回顾分析其临床特征、病理表现、首次治疗方案、诊疗经过及预后情况。结果23例患者中,13例行病灶扩大切除术,10例行扩大切除术联合辅助放疗。术后病理结果:PTT伴恶变者11例,良性者12例。患者初诊即明确诊断并规范治疗仅9例(39.13%),初次就诊时误诊14例(60.87%)。随访时间12~117个月,平均(35.8±19.3)个月。21例无复发、转移,2例复发。结论PTT好发于老年女性头皮,初诊确诊率较低,易误诊,常为结节性病变,不易发生转移。扩大切除术联合辅助放疗是治疗PTT的可靠方法。

Objective To explore the clinical characteristics,treatment and prognosis of proliferating trichilemmal tumor.Methods Clinical data of 23 patients admitted to the Department of Plastic Surgery,the First Affiliated Hospital of Xinjiang Medical University from January 2010 to January 2022 were collected.The clinical features,pathological manifestations,initial treatment,diagnosis and treatment course and prognosis were reviewed.Results Among the 23 patients,13 patients underwent enlarged excision and 10 patients underwent enlarged excision combined with adjuvant radiotherapy.Postoperative pathological results:PTT accompanied with malignant changes in 11 cases,12 cases benign.There were only 9 cases(39.13%)of patients with definite diagnosis and standard treatment at the first visit,and 14 cases(60.87%)of patients with misdiagnosis at the first visit.The mean follow-up time was(35.8±19.3)months from 12 to 117 months.There was no recurrence or metastasis in 21 cases and recurrence in 2 cases.Conclusion PTT tends to occur in the scalp of elderly women with a low rate of initial diagnosis and easy misdiagnosis.It is often a nodular lesion and not easy to metastasize.The first(first-time)physician has insufficient understanding of PTT and incomplete initial surgical resection is likely to lead to recurrence.Enlarged excision combined with adjuvant radiotherapy is a reliable method to treat PTT.