先天性皮脂腺瘤恶变

Malignant transformation of congenital sebaceoma:a case report

报告1例先天性皮脂腺瘤恶变。患者女,56岁。左上眼睑结节56年。皮肤科检查:左上眼睑一0.9 cm×0.9 cm黄褐色丘疹,质硬,表面结痂,边缘少许渗出,边界清楚;剥除表面痂皮后可见红色糜烂面。皮损组织病理检查:肿瘤由多个大小不等的分叶状团块组成,肿瘤团块由基底样细胞和少量皮脂腺细胞构成。免疫组化:上皮特异抗原(Ber-EP4)(-)、癌胚抗原(CEA)(-)、上皮膜抗原(EMA)(+)、雄性激素受体(AR)(+++)、p53(+++)、增殖核抗原(Ki-67)(20%+)。诊断:先天性皮脂腺瘤恶变为皮脂腺癌。予手术扩大切除肿瘤,目前术后随访中。

A case of malignant transformation of congenital sebaceoma is reported.A 56-year-old woman presented with a slow-growing,skin-colored nodule arising on the blephar of her left eye for 56 years.Physical examination showed a skin-colored papule measured approximately 0.9 cm x 0.9 cm,with rough surface and well-defined margins.There was erosion after the scab was removed.Histopathological examination showed solid nests and lobules of predominantly basaloid cells with pleiomorphic and enlarged nuclei.There were foci of sebocyte differentiation.The tumor cells were large,with distinct cell borders,and vacuo-lated cytoplasm.Immunohistochemical examination revealed that the tumor cells were positive for EMA,AR,p53,Ki-67(20%),and were negative for Ber-EP4 and CEA.The diagnosis of sebaceous carcinoma was made.The patient was followed up after a wide surgical excision.