Nazerali Rahim S, Tan Cynthia, Fung Maxwell A, Chen Steven L, Wong Michael S
From the *Division of Plastic Surgery, University of California Davis Medical Center; †School of Medicine, University of California Davis; ‡Departments of Dermatology and Pathology, University of California Davis Medical Center, Sacramento; and §Division of Surgical Oncology, City of Hope National Medical Center, Duarte, CA.
Ann Plast Surg. 2013 Apr;70(4):423-6. doi: 10.1097/SAP.0b013e318283d1cc.
Hidradenocarcinoma is a rare adnexal neoplasm representing the malignant counterpart of hidradenoma derived from eccrine sweat glands. Misdiagnosis of this disease is common due to the wide variety of histological patterns and rarity of this malignancy. We report an 87-year-old man presenting with a rare case of biopsy-proven hidradenocarcinoma of the finger. There is no standard care of treatment of hidradenocarcinoma, especially of those tumors in rare locations such as the fingers, given its rarity, variable tumor behavior and histology. Although limited treatment strategies exist, detailed data including TNM, location, histologic type and grade, and patient age should be gathered for optimal treatment strategy. The literature supports a 3-fold approach to these malignancies involving margin-free resection, sentinel lymph node biopsy to evaluate possible metastasis, and long-term follow-up given high risk of recurrence. Our treatment strategy involved a 4-fold, multidisciplinary approach involving reconstruction to optimize tumor-free remission and hand function.
汗腺癌是一种罕见的附属器肿瘤，是源自小汗腺的汗腺瘤的恶性对应物。由于这种恶性肿瘤的组织学模式多种多样且罕见，因此对该疾病的误诊很常见。我们报告了一名87岁男性，他患有经活检证实的手指汗腺癌，这是一例罕见病例。由于汗腺癌罕见、肿瘤行为和组织学多变，目前尚无针对汗腺癌的标准治疗方案，特别是对于手指等罕见部位的肿瘤。尽管存在有限的治疗策略，但应收集包括TNM、位置、组织学类型和分级以及患者年龄等详细数据，以制定最佳治疗方案。文献支持对这些恶性肿瘤采用三重方法，包括无边缘切除、前哨淋巴结活检以评估可能的转移，以及鉴于高复发风险进行长期随访。我们的治疗策略涉及四重多学科方法，包括重建以优化无瘤缓解和手部功能。
