Rose C
Dermatopathologie Lübeck, Maria-Goeppert-Str. 5, 23562, Lübeck, Deutschland,
Hautarzt. 2014 Dec;65(12):1030-6. doi: 10.1007/s00105-014-3531-7.
Tumors of the scalp display some clinical, histological and prognostic characteristics. Early recognition of tumors is hampered by dense hair growth which can result in delayed diagnosis.
Taking current literature into consideration atypical fibroxanthoma, cutaneous angiosarcoma, melanoma of the scalp, some adnexal tumors including the proliferating trichilemmal tumor as well as cutaneous metastases from visceral malignancies will be discussed.
Based on the fact that early scalp tumors are clinically difficult to recognize, they are often diagnosed at a late stage. Angiosarcomas belong to the most aggressive skin tumors and show a rapid growth with unfavorable prognosis. Malignant melanoma on the head has a more serious prognosis in comparison to other locations of the body. Cutaneous metastases are mostly a sign of an advanced tumor stage with a fatal prognosis. The various types of adnexal tumors are mostly benign. In exceptional cases rapid growth and ulceration may be an indicator for the development of an adnexal carcinoma. On the scalp tumors with sweat gland differentiation are more frequent than tumors with follicular differentiation. This shows that the general view that adnexal tumors develop from local adnexal structures is wrong.
Scalp lesions in which the diagnosis is unclear should be biopsied or excised early. Based on the result of the histological examination further therapy can be determined.
头皮肿瘤具有一些临床、组织学和预后特征。浓密的头发生长会阻碍肿瘤的早期识别，进而导致诊断延迟。
结合当前文献，将讨论非典型纤维黄色瘤、皮肤血管肉瘤、头皮黑色素瘤、一些附属器肿瘤（包括增生性外毛根鞘瘤）以及内脏恶性肿瘤的皮肤转移瘤。
鉴于早期头皮肿瘤在临床上难以识别，它们往往在晚期才被诊断出来。血管肉瘤是最具侵袭性的皮肤肿瘤之一，生长迅速且预后不佳。与身体其他部位相比，头部的恶性黑色素瘤预后更严重。皮肤转移瘤大多是肿瘤晚期的征象，预后不良。各种附属器肿瘤大多为良性。在特殊情况下，快速生长和溃疡可能是附属器癌发生的指标。在头皮上，具有汗腺分化的肿瘤比具有毛囊分化的肿瘤更常见。这表明附属器肿瘤由局部附属器结构发展而来的普遍观点是错误的。
诊断不明确的头皮病变应尽早进行活检或切除。根据组织学检查结果可确定进一步的治疗方案。
