Houtappel Mayke, Leguit Roos J, Sigurdsson Vigfus
Universitair Medisch Centrum Utrecht, Afd. Dermatologie en Allergologie, Utrecht, The Netherlands.
Ned Tijdschr Geneeskd. 2010;154:A1131.
A 58-year-old man presented at the dermatology outpatient clinic with a subcutaneous nodule on his left hand. The patient could not recall a previous injury. Excision revealed an epithelioid hemangioendothelioma, a rare and malignant vascular tumour, characterized by slow progression and often located on the upper and lower extremities. The patient was referred to a specialist group for soft-tissue tumours. He underwent excision, after which the wound was closed using a non-invasive adhesive wound closure. Since the excision was not very extensive, supplementary radiotherapy was given. Four years later there was no relapse or occurrence of metastases. Invasive investigation of a soft-tissue tumour, such as skin biopsy or diagnostic excision, may interfere with potential MRI - the diagnostic imaging tool indicated in the guidelines. However, a soft-tissue tumour is often only suspected at the last moment. When a soft-tissue tumour is suspected, the doctor should refer the patient to one of the specialist groups for soft-tissue tumours for further diagnosis and therapy.
一名58岁男性因左手出现皮下结节到皮肤科门诊就诊。患者回忆不起之前有过受伤情况。切除术后显示为上皮样血管内皮瘤，这是一种罕见的恶性血管肿瘤，其特点是进展缓慢，常位于上肢和下肢。该患者被转诊至软组织肿瘤专科小组。他接受了切除手术，术后使用无创粘性伤口闭合器闭合伤口。由于切除范围不是很大，所以进行了辅助放疗。四年后，未出现复发或转移情况。对软组织肿瘤进行侵入性检查，如皮肤活检或诊断性切除，可能会干扰潜在的MRI（指南中指出的诊断成像工具）。然而，软组织肿瘤往往在最后一刻才被怀疑。当怀疑有软组织肿瘤时，医生应将患者转诊至软组织肿瘤专科小组之一进行进一步诊断和治疗。
