BACKGROUND Microcystic adnexal carcinoma(MAC)is a rare malignant tumor of the skin that is commonly found on the face.It grows slowly and has a low mortality rate.However,for various reasons,including strong histologi...BACKGROUND Microcystic adnexal carcinoma(MAC)is a rare malignant tumor of the skin that is commonly found on the face.It grows slowly and has a low mortality rate.However,for various reasons,including strong histological invasiveness,clinical inexperience and inadequate procedure design,immediate or permanent facial deformity may occur after surgical operations.CASE SUMMARY This article describes a middle-aged female artist who was diagnosed with MAC on the left upper lip.She declined the recommended treatment plan,which included two-stage reconstruction,skin grafting,or surgery that could have resulted in obvious facial dysfunction or esthetic deformity.We accurately designed a personalized procedure involving a“jigsaw puzzle advancement flap”for the patient based on the lesion location and the estimated area of skin loss.The procedure was successful;both pathological R0 resection and immediate and long-term esthetic reconstruction effects were achieved.CONCLUSION This study suggests that when treating facial MAC or other skin malignancies,a surgical team should have sufficient plastic surgery-related knowledge and skills.An optimal surgical plan for an individual is needed to achieve good facial esthetics and functional recovery and shorten the treatment course.展开更多
BACKGROUND Microcystic adnexal carcinoma(MAC)is a rare malignant cutaneous adnexal neoplasm,often presenting as a flesh-colored and slow-growing indurated plaque or cystic nodule in the mid-facial region.Its character...BACKGROUND Microcystic adnexal carcinoma(MAC)is a rare malignant cutaneous adnexal neoplasm,often presenting as a flesh-colored and slow-growing indurated plaque or cystic nodule in the mid-facial region.Its characteristic indolent presentation usually leads to initial misdiagnosis,resulting in tumor mismanagement and added morbidity due to increased propensity for local invasion.CASE SUMMARY A 63-year-old Chinese male patient with a long-term history of excessive ultraviolet irradiation had received two surgeries for an“epidermal cyst”on his glabella and was presented to our hospital’s Dermatology Department for further diagnosis and therapy of the lesion on his glabella.One month ago,his two 7 mm×7 mm subcutaneous nodules were diagnosed as"recurrent epidermal cysts",and he underwent local excision surgery.Additionally,he has post medical history of surgery for right clear cell renal carcinoma.According to his biopsy,the patient was diagnosed as MAC in our hospital,and a tumor remnant was found on his wound.He then underwent wide local excision to achieve negative margins and reconstruction of full-thickness flap transplantation for tissue coverage.He remained tumor-free after six months of follow-up.CONCLUSION This case highlights the importance of MAC’s possible pathogenic factor of excessive ultraviolet exposure,its differential diagnosis to avoid misdiagnosis and mismanagement to adverse prognosis,the patient’s particular medical history of clear cell renal carcinoma,the alert for any tumor recurrence in older patients,and his uncommon multiple nodules mess consisting of two 7 mm×7 mm subcutaneous nodules,that will enrich the existing knowledge of MAC’s clinical features.展开更多
子宫内膜样癌伴有微乳头结构和微囊、伸长及碎片状(microcystic, elongated and fragmented,MELF)浸润者罕见。常州市第二人民医院收治1例52岁的女性子宫内膜样癌患者,其病理标本中出现了微乳头结构,微乳头形态类似乳腺浸润性微乳头状癌...子宫内膜样癌伴有微乳头结构和微囊、伸长及碎片状(microcystic, elongated and fragmented,MELF)浸润者罕见。常州市第二人民医院收治1例52岁的女性子宫内膜样癌患者,其病理标本中出现了微乳头结构,微乳头形态类似乳腺浸润性微乳头状癌,由簇状或小巢团状肿瘤细胞组成,缺乏纤维血管轴心,与周围组织存在空隙,异型性明显;在免疫组织化学染色中显示特征性的黏蛋白1外缘染色和E-钙黏蛋白杯状染色。肿瘤浸润前沿同时可见MELF浸润方式。肿瘤浸润深肌层,可见脉管癌栓和1枚淋巴结隐匿性癌转移。患者术后接受化学治疗和放射治疗,恢复良好,随访53个月无复发或转移。临床上此类病例具有高侵袭性的生物学行为,容易漏诊,需要予以重视。展开更多
目的:分析多层螺旋CT(multi-slice spiral CT,MSCT)在胰腺浆液性微囊腺瘤(serous microcystic adenoma of the pancreas,SCAP)、胰腺乏血供神经内分泌肿瘤(pancreatichypo-vascularizedneuroendocrinetumors,hypo-PNETs)中的鉴别效果与...目的:分析多层螺旋CT(multi-slice spiral CT,MSCT)在胰腺浆液性微囊腺瘤(serous microcystic adenoma of the pancreas,SCAP)、胰腺乏血供神经内分泌肿瘤(pancreatichypo-vascularizedneuroendocrinetumors,hypo-PNETs)中的鉴别效果与其影像特点。方法:回顾性分析2021年8月—2022年8月莒县碁山镇卫生院收治的经病理检查证实的78例SCAP与hypo-PNETs患者的临床资料,全部患者均进行MSCT检查,以病理检查结果为“金标准”,统计MSCT检查的诊断符合率;另分析SCAP与hypo-PNETs的影像特点差异。结果:病理检查显示:78例患者中,SCAP共40例,hypo-PNETs共38例。MSCT检查共检出39例SCAP,38例hypoPNETs,总诊断符合率为98.72%(77/78);hypo-PNETs边界不清占比为77.50%(31/40)、无纤维间隔占比为80.00%(32/40)、动脉期强化占比为87.50%(35/40)、无浮云征占比为75.00%(30/38)、有转移或侵犯占比为80.00%(32/40),高于SCAP患者的21.05%(8/38)、26.32%(10/38)、44.74%(17/38)、26.68%(9/38)、0.00%,差异有统计学意义(P<0.05);而两者的部位、形态、胰管扩张、密度、钙化情况相比,差异无统计学意义(P>0.05)。结论:MSCT在SCAP、hypo-PNETs鉴别诊断中效果显著,而SCAP、hypo-PNETs两者的影像学特点存在较大差异,可为临床提供可靠的参考,值得临床大力推广。展开更多
文摘BACKGROUND Microcystic adnexal carcinoma(MAC)is a rare malignant tumor of the skin that is commonly found on the face.It grows slowly and has a low mortality rate.However,for various reasons,including strong histological invasiveness,clinical inexperience and inadequate procedure design,immediate or permanent facial deformity may occur after surgical operations.CASE SUMMARY This article describes a middle-aged female artist who was diagnosed with MAC on the left upper lip.She declined the recommended treatment plan,which included two-stage reconstruction,skin grafting,or surgery that could have resulted in obvious facial dysfunction or esthetic deformity.We accurately designed a personalized procedure involving a“jigsaw puzzle advancement flap”for the patient based on the lesion location and the estimated area of skin loss.The procedure was successful;both pathological R0 resection and immediate and long-term esthetic reconstruction effects were achieved.CONCLUSION This study suggests that when treating facial MAC or other skin malignancies,a surgical team should have sufficient plastic surgery-related knowledge and skills.An optimal surgical plan for an individual is needed to achieve good facial esthetics and functional recovery and shorten the treatment course.
文摘BACKGROUND Microcystic adnexal carcinoma(MAC)is a rare malignant cutaneous adnexal neoplasm,often presenting as a flesh-colored and slow-growing indurated plaque or cystic nodule in the mid-facial region.Its characteristic indolent presentation usually leads to initial misdiagnosis,resulting in tumor mismanagement and added morbidity due to increased propensity for local invasion.CASE SUMMARY A 63-year-old Chinese male patient with a long-term history of excessive ultraviolet irradiation had received two surgeries for an“epidermal cyst”on his glabella and was presented to our hospital’s Dermatology Department for further diagnosis and therapy of the lesion on his glabella.One month ago,his two 7 mm×7 mm subcutaneous nodules were diagnosed as"recurrent epidermal cysts",and he underwent local excision surgery.Additionally,he has post medical history of surgery for right clear cell renal carcinoma.According to his biopsy,the patient was diagnosed as MAC in our hospital,and a tumor remnant was found on his wound.He then underwent wide local excision to achieve negative margins and reconstruction of full-thickness flap transplantation for tissue coverage.He remained tumor-free after six months of follow-up.CONCLUSION This case highlights the importance of MAC’s possible pathogenic factor of excessive ultraviolet exposure,its differential diagnosis to avoid misdiagnosis and mismanagement to adverse prognosis,the patient’s particular medical history of clear cell renal carcinoma,the alert for any tumor recurrence in older patients,and his uncommon multiple nodules mess consisting of two 7 mm×7 mm subcutaneous nodules,that will enrich the existing knowledge of MAC’s clinical features.
文摘子宫内膜样癌伴有微乳头结构和微囊、伸长及碎片状(microcystic, elongated and fragmented,MELF)浸润者罕见。常州市第二人民医院收治1例52岁的女性子宫内膜样癌患者,其病理标本中出现了微乳头结构,微乳头形态类似乳腺浸润性微乳头状癌,由簇状或小巢团状肿瘤细胞组成,缺乏纤维血管轴心,与周围组织存在空隙,异型性明显;在免疫组织化学染色中显示特征性的黏蛋白1外缘染色和E-钙黏蛋白杯状染色。肿瘤浸润前沿同时可见MELF浸润方式。肿瘤浸润深肌层,可见脉管癌栓和1枚淋巴结隐匿性癌转移。患者术后接受化学治疗和放射治疗,恢复良好,随访53个月无复发或转移。临床上此类病例具有高侵袭性的生物学行为,容易漏诊,需要予以重视。
文摘目的:分析多层螺旋CT(multi-slice spiral CT,MSCT)在胰腺浆液性微囊腺瘤(serous microcystic adenoma of the pancreas,SCAP)、胰腺乏血供神经内分泌肿瘤(pancreatichypo-vascularizedneuroendocrinetumors,hypo-PNETs)中的鉴别效果与其影像特点。方法:回顾性分析2021年8月—2022年8月莒县碁山镇卫生院收治的经病理检查证实的78例SCAP与hypo-PNETs患者的临床资料,全部患者均进行MSCT检查,以病理检查结果为“金标准”,统计MSCT检查的诊断符合率;另分析SCAP与hypo-PNETs的影像特点差异。结果:病理检查显示:78例患者中,SCAP共40例,hypo-PNETs共38例。MSCT检查共检出39例SCAP,38例hypoPNETs,总诊断符合率为98.72%(77/78);hypo-PNETs边界不清占比为77.50%(31/40)、无纤维间隔占比为80.00%(32/40)、动脉期强化占比为87.50%(35/40)、无浮云征占比为75.00%(30/38)、有转移或侵犯占比为80.00%(32/40),高于SCAP患者的21.05%(8/38)、26.32%(10/38)、44.74%(17/38)、26.68%(9/38)、0.00%,差异有统计学意义(P<0.05);而两者的部位、形态、胰管扩张、密度、钙化情况相比,差异无统计学意义(P>0.05)。结论:MSCT在SCAP、hypo-PNETs鉴别诊断中效果显著,而SCAP、hypo-PNETs两者的影像学特点存在较大差异,可为临床提供可靠的参考,值得临床大力推广。
