Haruyama Sanehito, Sugita Kazunari, Kawakami Chika, Nakamura Motonobu, Tokura Yoshiki
Department of Dermatology, School of Medicine, University of Occupational and Environmental Health, Yahatanishi-ku, Kitakyushu 807-8555, Japan.
J UOEH. 2010 Jun 1;32(2):155-9. doi: 10.7888/juoeh.32.155.
Cutaneous squamous cell carcinoma (SCC) frequently metastasizes to lymph nodes, but metastasis to the spine is rare. We report a case of cutaneous SCC with metastasis to a particularly rare region, the thoracic spine, which evolved into a spinal cord compression. In November 2005, a 73-year-old man underwent a resection of a primary tumor and standard inguinal lymphadenectomy for a cutaneous SCC of the right fourth toe, defined as T2N1M1 stage. Over the next 3 years, he was given peplomycin, CAV (cisplatin, adriamycin, and vindesine) therapy and radiotherapy for multiple lymph node metastases. In September 2008, he complained of back pain and urinary retention. Magnetic resonance imaging of the thoracic spine showed the presence of masses in the vertebral body, which compressed the spinal cord. Blood examination revealed an elevated level of serum SCC antigen. After irradiation and chemotherapy, the patient's complaint was relieved and the level of serum SCC antigen concomitantly declined. Spinal metastasis is one of the items to be kept in mind during the follow-up of patients with cutaneous SCC.
皮肤鳞状细胞癌(SCC)常转移至淋巴结,但转移至脊柱则较为罕见。我们报告一例皮肤SCC转移至一个特别罕见的部位——胸椎,并发展为脊髓压迫症的病例。2005年11月,一名73岁男性因右足第四趾皮肤SCC接受了原发肿瘤切除及标准腹股沟淋巴结清扫术,分期为T2N1M1期。在接下来的3年里,他因多处淋巴结转移接受了培普利霉素、CAV(顺铂、阿霉素和长春地辛)治疗及放疗。2008年9月,他出现背痛和尿潴留。胸椎磁共振成像显示椎体有肿块,压迫脊髓。血液检查显示血清SCC抗原水平升高。经过放疗和化疗后,患者的症状得到缓解,血清SCC抗原水平也随之下降。脊柱转移是皮肤SCC患者随访过程中需要留意的事项之一。