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外阴小汗腺癌:一例病例报告及文献复习

Eccrine porocarcinoma of the vulva: a case report and review of the literature.

作者信息

Fujimine-Sato Ayako, Toyoshima Masafumi, Shigeta Shogo, Toki Asami, Kuno Takashi, Sato Izumi, Watanabe Mika, Niikura Hitoshi, Yaegashi Nobuo

机构信息

Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1, Seiryo, Aoba, Sendai, 980-8574, Japan.

Present address: Department of Obstetrics and Gynecology, Sendai Red Cross Hospital, 2-43-3, Yagiyama-honcho, Taihaku, Sendai, Japan.

出版信息

J Med Case Rep. 2016 Nov 10;10(1):319. doi: 10.1186/s13256-016-1106-1.

Abstract

BACKGROUND

Malignant tumors arising from the vulva account for only 0.6 % of all cancers in female patients. The predominant histologic type, representing about 90 % of these malignancies, is squamous cell carcinoma. Eccrine porocarcinoma is a rare malignant tumor arising from sweat glands. The incidence of eccrine porocarcinoma is estimated at 0.005-0.01 % of all cutaneous tumors. To the best of our knowledge, only seven previous cases of vulvar eccrine porocarcinoma have been reported in the English-language literature. We present the case of a patient with eccrine porocarcinoma of the vulva, and we summarize the clinical features of this disease using seven previously reported cases.

CASE PRESENTATION

A 54-year-old Japanese woman visited a local hospital complaining of fever and left vulvar pain for 2 months. An initial examination revealed a 1 × 1 cm, firm, ulcerative mass in the inner aspect of the left labium minorum. With a preoperative diagnosis of vulvar squamous cell carcinoma, we performed a radical local excision followed by bilateral inguinal lymphadenectomy. Histological examination showed eccrine porocarcinoma, stage IB (T1bN0M0). Radiation therapy with weekly cisplatin administration was then given as adjuvant therapy. One month after treatment was completed, computed tomography revealed multiple metastases in the bilateral lungs and in the sacral bone. The patient received three courses of chemotherapy (paclitaxel and carboplatin) and underwent palliative radiation therapy to the sacrum. She died of her disease 12 months after surgery.

CONCLUSIONS

We report the case of a patient with eccrine porocarcinoma of the vulva and summarize the clinical features and the treatment options of eccrine porocarcinoma from a few retrospective case reports. Although eccrine porocarcinoma is a rare disease, clinicians and pathologists should be aware of its clinical and histological features and its biological behavior.

摘要

背景

外阴恶性肿瘤仅占女性患者所有癌症的0.6%。主要的组织学类型是鳞状细胞癌,约占这些恶性肿瘤的90%。小汗腺汗孔癌是一种起源于汗腺的罕见恶性肿瘤。小汗腺汗孔癌的发病率估计占所有皮肤肿瘤的0.005 - 0.01%。据我们所知,英文文献中仅报道过7例既往外阴小汗腺汗孔癌病例。我们报告1例外阴小汗腺汗孔癌患者的病例,并结合7例既往报道病例总结该病的临床特征。

病例介绍

一名54岁日本女性因发热及左侧外阴疼痛2个月就诊于当地医院。初步检查发现左侧小阴唇内侧有一个1×1 cm、质地硬、溃疡型肿物。术前诊断为外阴鳞状细胞癌,我们进行了根治性局部切除,随后行双侧腹股沟淋巴结清扫术。组织学检查显示为小汗腺汗孔癌,IB期(T1bN0M0)。然后给予每周顺铂给药的放射治疗作为辅助治疗。治疗完成1个月后,计算机断层扫描显示双侧肺及骶骨多发转移。患者接受了3个疗程的化疗(紫杉醇和卡铂),并对骶骨进行了姑息性放射治疗。她在术后12个月死于该疾病。

结论

我们报告1例外阴小汗腺汗孔癌患者的病例,并从一些回顾性病例报告中总结小汗腺汗孔癌的临床特征及治疗选择。尽管小汗腺汗孔癌是一种罕见疾病,但临床医生和病理医生应了解其临床、组织学特征及其生物学行为。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/429a/5105286/db0859566222/13256_2016_1106_Fig1_HTML.jpg

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