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化脓性汗腺炎继发鳞状细胞癌的成功手术治疗:一例报告及文献综述

Successful surgical treatment for squamous cell carcinoma arising from hidradenitis suppurativa: A case report and literature review.

作者信息

Huang Cheng, Lai Zhichao, He Mu, Zhai Biyun, Zhou Liangrui, Long Xiao

机构信息

Division of Plastic and Reconstructive Surgery, Peking Union Medical College Hospital, Beijing, P.R. China Department of Medicine, the University of Melbourne, Parkville, Victoria, Australia Department of Pathology, Peking Union Medical College Hospital, Beijing, P.R. China.

出版信息

Medicine (Baltimore). 2017 Jan;96(3):e5857. doi: 10.1097/MD.0000000000005857.

Abstract

RATIONALE

Hidradenitis suppurativa (HS) is a disabling inflammatory disease mainly affecting apocrine glands. Marjolin ulcer (MU) is a term used to describe a rare type of squamous cell carcinoma (SCC) arising within sites of chronic wounds or preexisting scars. Chronic HS may result in a rare type of SCC, MU, which has a poor prognosis due to its high metastatic rate.

CONCERNS OF THE PATIENT

Here we reported a 60-year-old male who developed SCC on the right buttock after suffering from HS for 15 years.

INTERVENTIONS

Radical resection with clear margin was performed, after which topical negative pressure (TNP) was applied followed by split-thickness skin grafting.

OUTCOMES

In a 1-year follow-up, there was no recurrence of malignancy.

LESSONS

Cases reported in English literature since 1991 were reviewed to get a general grasp of status quo. The authors conclude that chronic HS lesion especially in the gluteal region should be cautiously observed. Once tumor arisen from HS lesion, immediate radical excision should be performed. With assured clear margin, TNP could be chosen to offer a favorable environment for the survival of skin grafting.

摘要

理论依据

化脓性汗腺炎(HS)是一种致残性炎症性疾病,主要影响顶泌汗腺。Marjolin溃疡(MU)是用于描述在慢性伤口部位或既往瘢痕内发生的一种罕见鳞状细胞癌(SCC)的术语。慢性HS可能导致一种罕见的SCC类型,即MU,由于其高转移率,预后较差。

患者情况

在此,我们报告一名60岁男性,在患HS 15年后,右侧臀部发生了SCC。

干预措施

进行了切缘清晰的根治性切除,之后应用局部负压(TNP),然后进行中厚皮片移植。

结果

在1年的随访中,无恶性肿瘤复发。

经验教训

回顾了自1991年以来英文文献报道的病例,以全面了解现状。作者得出结论,应谨慎观察慢性HS病变,尤其是臀部区域的病变。一旦HS病变发生肿瘤,应立即进行根治性切除。在确保切缘清晰的情况下,可选择TNP为皮片存活提供有利环境。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a18/5279087/0a08419ad487/medi-96-e5857-g001.jpg

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