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[皮肤基底鳞状细胞癌]

[Cutaneous basosquamous cell carcinoma].

作者信息

Lehnerdt G, Manz D, Jahnke K, Schmitz K J

机构信息

Universitäts-Hals-Nasen-Ohrenklinik, Universität Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Deutschland.

出版信息

HNO. 2008 Mar;56(3):306-11. doi: 10.1007/s00106-007-1559-z.

Abstract

BACKGROUND

Basosquamous carcinoma (BSC) is a rare malignancy with specific histopathological features of both basal cell (BCC) and squamous cell carcinoma (SCC). Therefore, the histological diagnosis is challenging. Due to its low incidence there is no consensus on the surgical management of BSC.

PATIENTS AND METHODS

We describe the (immunohistological) diagnostic and therapeutic aspects of nine cases (8 male symbol : 1 female symbol, on average 68.6 years of age (range: 47-81)) of BSC. Of these, seven were located on the pinna, one on the forehead and zygomatic region and one in the retroauricular region.

RESULTS

Immunochemical staining for epithelial membrane antigen was negative (apart from the typical areas of epithelial pearl formation) and BerEP4 was positive in all cases. Therapy consisted of partial removal of the pinna in four, and total removal in three cases. One patient was treated by partial removal of the auricle with superficial parotidectomy and ipsilateral neck dissection. In the case of the carcinoma on the forehead, a local excision was performed. The median follow-up was 45 months. One patient had a local recurrence.

CONCLUSIONS

The histological diagnosis of BSC is confirmed by the use of EMA and BerEP4 immunohistological staining. Clinically, BSC is a rare, aggressive skin tumor. Despite the histological similarity to basal cell carcinoma, BSC has an imminent risk of metastasizing. Hence, therapy should be similar to that for SCC, taking into consideration the age and general state of the usually elderly patient.

摘要

背景

基底鳞状细胞癌(BSC)是一种罕见的恶性肿瘤,具有基底细胞癌(BCC)和鳞状细胞癌(SCC)的特定组织病理学特征。因此,组织学诊断具有挑战性。由于其发病率低,关于BSC的手术治疗尚无共识。

患者与方法

我们描述了9例BSC患者(8例男性∶1例女性,平均年龄68.6岁(范围:47 - 81岁))的(免疫组织学)诊断和治疗情况。其中,7例位于耳廓,1例位于前额和颧区,1例位于耳后区域。

结果

上皮膜抗原免疫化学染色均为阴性(除典型的上皮珠形成区域外),而BerEP4在所有病例中均为阳性。治疗方法包括4例耳廓部分切除,3例全切除。1例患者接受耳廓部分切除加腮腺浅叶切除术和同侧颈部淋巴结清扫术。对于前额部的癌,行局部切除术。中位随访时间为45个月。1例患者出现局部复发。

结论

EMA和BerEP4免疫组织学染色可确诊BSC的组织学诊断。临床上,BSC是一种罕见的侵袭性皮肤肿瘤。尽管在组织学上与基底细胞癌相似,但BSC有转移的紧迫风险。因此,治疗应类似于SCC,同时考虑到通常为老年患者的年龄和一般状况。

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