Division of Neurosurgery, Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan.
J Neurooncol. 2010 Sep;99(2):273-6. doi: 10.1007/s11060-010-0116-x. Epub 2010 Jan 13.
Malignant sweat gland tumors are rare neoplasms with high recurrence and metastasis rates of over 50%. Clinically, they are often either not diagnosed or diagnosed improperly and are encountered as a histological surprise. Herein, we report a 50-year-old woman who suffered from chronic headaches and a left-side limping gait. Magnetic resonance imaging revealed a T1 and T2 heterogeneous intense dural-based lesion at right-frontal convexity. The pathological diagnosis of papillary meningioma was rendered at the time. Because there was no evidence of residual tumor, tumor recurrence, or distant metastases during the three-year follow-up, the clinician believed questioning the initial diagnosis was warranted. After pathological review, the final diagnosis was low-grade hidradenocarcinoma. A review of the literature suggests this is the first reported case of dural-based hidradenocarcinoma with local brain invasion. Given the lack of scalp or skull bone involvement, we speculated that the tumor may have arisen from ectopic sweat gland cells entrapped in the dural mater.
恶性汗腺肿瘤是罕见的肿瘤，其复发和转移率超过 50%。临床上，它们经常被误诊或漏诊，被认为是组织学上的意外发现。在此，我们报告了一位 50 岁女性，她患有慢性头痛和左侧跛行步态。磁共振成像显示右侧额凸有 T1 和 T2 不均匀强化的硬脑膜病变。当时的病理诊断为乳头状脑膜瘤。由于在三年的随访中没有肿瘤残留、复发或远处转移的证据，临床医生认为有理由质疑最初的诊断。经过病理复查，最终诊断为低级别汗腺癌。文献复习提示这是首例报道的硬脑膜内汗腺癌伴局部脑侵犯。鉴于没有头皮或颅骨受累，我们推测肿瘤可能来源于被困在硬脑膜中的异位汗腺细胞。
