Romeu M, Foletti J M, Chossegros C, Dales J P, Berbis P, Cribier B, Guyot L
Service de stomatologie, chirurgie maxillo-faciale et plastique, hôpital Nord, centre hospitalier des Bourrely, 13015 Marseille, France.
Service de stomatologie, chirurgie maxillo-faciale et plastique, hôpital Nord, centre hospitalier des Bourrely, 13015 Marseille, France.
J Stomatol Oral Maxillofac Surg. 2017 Apr;118(2):95-102. doi: 10.1016/j.jormas.2017.01.001. Epub 2017 Mar 23.
Malignant cutaneous adnexal neoplasms are rare and have been characterized only recently. They can occur at any age but preferentially in elderly. There are 3 of them: trichoblastic carcinoma, trichilemmal carcinoma and malignant pilomatricoma. The aim of our study was to make a diagnostic and therapeutic update about these tumors when located at the face or at the scalp.
A bibliographic research was made on PubMed using following keywords: appendage skin carcinoma AND pathology AND/OR therapeutic. Articles published before 2000 were considered outdated and were excluded.
Twenty-five articles met the inclusion criteria. Clinical presentation was non-specific. Histological examination only allowed for diagnosis. Lesions were locally or loco-regionally aggressive. Lymphatic or hematogenous metastasis were reported. No consensus about treatment was found. When surgery was used, it consisted in resection with safety margins ranging from 0.5 to 3cm depending on the teams. In case of metastasis, treatment consisted in chemo- and/or radiotherapy. A quarterly medical monitoring was recommended.
Malignant cutaneous adnexal tumors are rare. There is nowadays no treatment consensus. An initial staging by mean of a head and neck, chest, abdominal and pelvic CT-scan is mandatory. Treatment has to be decided in a multidisciplinary cancer committee. In the absence of metastasis, the reference treatment is surgical resection, possibly by Mohs micrographic technique, with large safety margins. In case of metastasis or if the loco-regional extension does not allow for a complete excision, chemotherapy and/or radiotherapy may be proposed. A close monitoring is essential.
恶性皮肤附属器肿瘤较为罕见，直到最近才得到明确的特征描述。它们可发生于任何年龄，但多见于老年人。主要有三种：毛母质癌、外毛根鞘癌和恶性毛发上皮瘤。我们研究的目的是对这些位于面部或头皮的肿瘤进行诊断和治疗方面的更新。
在PubMed上进行文献检索，使用以下关键词：附属器皮肤癌、病理学和/或治疗。2000年以前发表的文章被视为过时，予以排除。
25篇文章符合纳入标准。临床表现无特异性。仅通过组织学检查才能确诊。病变具有局部或区域侵袭性。有淋巴或血行转移的报道。未发现关于治疗的共识。采用手术治疗时，根据不同团队，切除范围的安全切缘为0.5至3厘米。发生转移时，治疗包括化疗和/或放疗。建议每季度进行医学监测。
恶性皮肤附属器肿瘤较为罕见。目前尚无治疗共识。必须通过头颈部、胸部、腹部和盆腔CT扫描进行初步分期。治疗方案需在多学科癌症委员会中确定。在无转移的情况下，参考治疗方法是手术切除，可能采用莫氏显微外科技术，切缘要足够宽。发生转移或局部区域扩展无法完全切除时，可考虑化疗和/或放疗。密切监测至关重要。
