Bottoni U, Innocenzi D, Mannooranparampil T J, Richetta A, Del Giudice M, Calvieri S
Istituto di Dermatologia, Viale Del Policlinico-155, 00161 Roma, Italy.
Eur J Dermatol. 2001 Mar-Apr;11(2):124-6.
The authors report the case of a 64-year-old man who presented with erythematous infiltrating plaques sited on his right supraclavicular and infraclavicular regions. Five years before a laryngeal epidermoid carcinoma had been surgically removed. After two years the patient underwent lymphadenectomy and radiotherapy for the presence of metastasis in his right cervical lymph nodes. He was disease free until two months before our examination when small red spots appeared on his right supraclavicular region, slightly enlarging. A skin biopsy was performed and histological examination showed the presence of metastatic cells inside dilated lymphatic vessels. Immunohistochemical markers showed only positive staining of atypical cells with monoclonal anti-cytokeratin antibodies (cytokeratin B-ORTHO=34betaE12) confirming the epithelial origin of metastastic cells. A diagnosis of inflammatory cutaneous metastasis from laryngeal epidermoid carcinoma was given. This type of metastasis has been frequently observed in patients with breast carcinoma and it has also been described during the course of other malignant tumours. Malignant tumour of the larynx generally spreads to regional lymph nodes or, through blood, to the lungs. Skin metastasis have rarely been described, and always as multiple or solitary nodules. According to our knowledge this is the first case of inflammatory cutaneous metastasis from laryngeal epidermoid carcinoma reported in the literature.
作者报告了一例64岁男性病例，该患者右锁骨上和锁骨下区域出现红斑浸润性斑块。5年前，其喉表皮样癌已通过手术切除。两年后，患者因右颈部淋巴结转移接受了淋巴结切除术和放疗。在我们检查前两个月，他一直无病，直到右锁骨上区域出现小红点，并略有增大。进行了皮肤活检，组织学检查显示扩张的淋巴管内存在转移细胞。免疫组化标记仅显示非典型细胞用单克隆抗细胞角蛋白抗体（细胞角蛋白B-ORTHO=34βE12）呈阳性染色，证实转移细胞的上皮来源。诊断为喉表皮样癌的炎性皮肤转移。这种转移类型在乳腺癌患者中经常观察到，在其他恶性肿瘤病程中也有描述。喉恶性肿瘤通常扩散至区域淋巴结，或通过血液扩散至肺部。皮肤转移很少被描述，且总是表现为多发或孤立结节。据我们所知，这是文献中报道的首例喉表皮样癌炎性皮肤转移病例。
