Antley C A, Carney M, Smoller B R
Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, USA.
J Cutan Pathol. 1999 Jan;26(1):48-50. doi: 10.1111/j.1600-0560.1999.tb01790.x.
While there are several reports of microcystic adnexal carcinoma developing in patients within sites of previous therapeutic irradiation, this relationship is not well described in the dermatologic literature. We report a case of a 42-year-old man with a remote history of therapeutic irradiation following surgical resection of periorbital rhabdomyosarcoma. Subsequently, he developed multiple basal cell carcinomas and a microcystic adnexal carcinoma within the field of irradiation. The histologic features were those of a classic microcystic adnexal carcinoma, with well differentiated nests and cords of keratinocytes displaying follicular and ductular differentiation infiltrating diffusely into the reticular dermis. Dense fibrosis was present surrounding the neoplastic keratinocytes. Nuclear atypia and mitotic figures were not identified. A carcinoembryonic antigen (CEA) stain demonstrated glandular differentiation. It is important for dermatologists to be aware of the apparent relationship between the rare microcystic adnexal carcinoma with its innocuous scar-like clinical appearance and prior local radiation therapy.
虽然有几篇关于微囊性附属器癌在既往接受过治疗性放疗的患者部位发生的报道，但皮肤病学文献中对这种关系的描述并不充分。我们报告一例42岁男性，其在眼眶周围横纹肌肉瘤手术切除后有既往治疗性放疗史。随后，他在放疗区域内发生了多发基底细胞癌和一例微囊性附属器癌。组织学特征为典型的微囊性附属器癌，有分化良好的角质形成细胞巢和索，显示出毛囊和导管分化，弥漫性浸润至网状真皮。肿瘤性角质形成细胞周围存在致密纤维化。未发现核异型性和有丝分裂象。癌胚抗原（CEA）染色显示有腺体分化。皮肤科医生应意识到罕见的微囊性附属器癌与其无害的瘢痕样临床表现和既往局部放疗之间的明显关系，这一点很重要。
