Sohsman Marie, Yang Hui-Min, Cassarino David S
Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, University of California-Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA.
J Cutan Pathol. 2010 Dec;37(12):1241-4. doi: 10.1111/j.1600-0560.2009.01394.x.
Sinonasal undifferentiated carcinoma (SNUC) is an aggressive malignancy of disputed histogenesis that arises in the sinonasal tract and has an extremely poor prognosis. Despite multimodality treatment with surgical resection, radiation, and chemotherapy, recurrence is common. The tumor spreads by direct local extension, but also metastasizes to lymph nodes, brain, lung and bone. To date, reports of metastasis to the skin have not been published. We report a case of a 58-year-old woman diagnosed with SNUC who underwent surgical resection of the tumor followed by chemoradiation. The tumor soon recurred, and she required wide re-excision. Two months after this procedure, she developed multiple dermal nodules in the head and neck region, clinically suspicious for metastases. Biopsy of a nodule from the right neck revealed a poorly differentiated carcinoma, with morphological and immunohistochemical findings consistent with a metastasis of the patient's known SNUC. We conclude that the skin may be a rare site of metastasis of SNUC, and in some cases may be the presenting sign of tumor recurrence despite aggressive multimodality treatment.
鼻窦未分化癌（SNUC）是一种组织发生存在争议的侵袭性恶性肿瘤，起源于鼻窦，预后极差。尽管采用了手术切除、放疗和化疗等多模式治疗，但复发很常见。肿瘤通过局部直接蔓延扩散，但也会转移至淋巴结、脑、肺和骨。迄今为止，尚未有皮肤转移的报道。我们报告一例58岁女性，诊断为SNUC，接受了肿瘤手术切除，随后进行了放化疗。肿瘤很快复发，她需要广泛再次切除。此次手术后两个月，她在头颈部出现多个皮肤结节，临床怀疑为转移灶。对右侧颈部一个结节进行活检，显示为低分化癌，其形态学和免疫组化结果与患者已知的SNUC转移相符。我们得出结论，皮肤可能是SNUC罕见的转移部位，在某些情况下，尽管进行了积极的多模式治疗，皮肤转移可能是肿瘤复发的首发征象。
