Marra Diego E, Schanbacher Carl F, Torres Abel
Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, and Mohs Surgery Center, Dana Farber Cancer Institute, Boston, Massachusetts 02115, USA.
Dermatol Surg. 2004 May;30(5):799-802. doi: 10.1111/j.1524-4725.2004.30223.x.
Primary cutaneous mucinous carcinoma is a rare adnexal malignancy with a high recurrence rate following conventional excision and the potential for aggressive local invasion.
To enhance the microscopic detection of mucinous carcinoma in Mohs micrographic surgical sections by incorporating rapid immunohistochemical staining.
Standard Mohs micrographic surgical technique was used in conjunction with frozen section immunohistochemistry using an antibody to low-molecular-weight cytokeratin.
Rapid immunoperoxidase staining using low-molecular-weight cytokeratin detected residual foci of mucinous carcinoma that were difficult to identify on routine frozen sections. Immunostaining was strongly positive in areas with clear evidence of tumor by routine histology, as well as in adjacent areas on a subsequent stage where frozen sections were equivocal or negative. Immunostaining was distinctly negative at the final surgical margin, which was shown by en face permanent sections to be free of tumor. The patient has been free of recurrence for 3 years.
Immunoperoxidase-guided Mohs micrographic surgery using low-molecular-weight cytokeratin enhances the sensitivity for detection of mucinous carcinoma, and may help contribute to complete tumor removal.
原发性皮肤黏液癌是一种罕见的附属器恶性肿瘤，常规切除后复发率高，且有局部侵袭性生长的可能。
通过快速免疫组化染色提高莫氏显微外科手术切片中黏液癌的显微镜下检出率。
标准的莫氏显微外科技术联合使用抗低分子量细胞角蛋白抗体的冰冻切片免疫组化。
使用低分子量细胞角蛋白进行快速免疫过氧化物酶染色可检测到常规冰冻切片上难以识别的黏液癌残留病灶。在常规组织学明确有肿瘤证据的区域以及后续阶段冰冻切片结果不明确或为阴性的相邻区域，免疫染色呈强阳性。在最终手术切缘免疫染色明显为阴性，经整体永久切片证实无肿瘤。该患者已无复发3年。
使用低分子量细胞角蛋白的免疫过氧化物酶引导的莫氏显微外科手术提高了黏液癌的检测敏感性，并可能有助于实现肿瘤的完整切除。
