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[局限性硬皮病中的鳞状细胞癌]

[Squamous cell carcinoma in localized scleroderma].

作者信息

Durčanská V, Jedličková H, Sláma O, Velecký L, Březinová E, Vašků V

出版信息

Klin Onkol. 2014;27(6):434-7. doi: 10.14735/amko2014434.

Abstract

We present a case of a young 26-year-old woman, who has been suffering from localised scleroderma (morphea) for 15 years. Recently, a lesion on the dorsum of her right foot ulcerated. Based on a CT scan and X-ray a diagnosis of ulcerative osteomyellitis was established. The patient was treated with a combination of antibiotics. Subsequent histological examinations showed granulomatous tissue and chronic inflammatory changes on top of pseudoepiteliomatous hyperplasia. The patients status was deteriorating, which resulted in a limb amputation under the knee. Three months later, there was a metastasis of squamous cell carcinoma found in the patients inguinal lymph node. In spite of combined therapy (surgery, radioterapy and systemic chemotherapy), new metastases occurred and the patient succumbed to the disease several months afterwards. The case was concluded as a squamous cell carcinoma camouflaged by osteomyelitis. Malignant turn of localised sclerodema is very rare. It usually occurs on the lower extremities of patients with a long course of the disease and is associated with pansclerotic or generalised variants of morphea.

摘要

我们报告一例26岁年轻女性病例,她患局限性硬皮病(硬斑病)已有15年。最近,她右脚背部的一处皮损发生溃疡。基于CT扫描和X线检查,确诊为溃疡性骨髓炎。患者接受了抗生素联合治疗。随后的组织学检查显示,在假上皮瘤样增生之上有肉芽肿组织和慢性炎症改变。患者病情不断恶化,最终进行了膝下截肢手术。三个月后,在患者腹股沟淋巴结发现了鳞状细胞癌转移。尽管进行了联合治疗(手术、放疗和全身化疗),仍出现了新的转移灶,患者在数月后死于该病。该病例最终诊断为被骨髓炎掩盖的鳞状细胞癌。局限性硬皮病恶变非常罕见。它通常发生在病程较长的患者下肢,且与硬斑病的泛硬化型或全身型有关。

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