Tolkachjov Stanislav N
Surgical Dermatology Group, Birmingham, Alabama.
Dermatol Surg. 2017 Oct;43(10):1199-1207. doi: 10.1097/DSS.0000000000001167.
Adnexal carcinomas (ACs) are rare cutaneous malignancies of sweat gland or pilosebaceous origin. Optimal treatment and metastatic potential of AC are poorly defined. Mohs micrographic surgery (MMS) has been increasingly used to treat AC.
To review selected primary cutaneous AC and their treatment outcomes with MMS.
Literature review using PubMed search for articles related to primary cutaneous ACs.
Sebaceous carcinoma treated with MMS recurred and metastasized in 6.4% and 3.7%, respectively. Primary cutaneous mucinous carcinoma treated with MMS recurred and metastasized in 9.6% and 6.4%, respectively. After MMS, 4.7% of microcystic AC recurred with no reported metastases. After MMS, recurrences and metastases of trichilemmal carcinoma or hidradenocarcinoma have not been reported. Two (4.2%) regional lymph node metastases but no distant metastases or local recurrences have been reported in eccrine porocarcinoma. Squamoid eccrine duct tumor, pilomatrix carcinoma, and spiradenocarcinoma treated with MMS are also reviewed.
The rarity of ACs and the lack of comparative data on treatment makes conclusive recommendations on treatment difficult. Recent large case series and reviews suggest MMS is a useful and possibly superior treatment for AC and should be considered if primary cutaneous disease is suspected.
附件癌（ACs）是起源于汗腺或皮脂腺的罕见皮肤恶性肿瘤。AC的最佳治疗方法和转移潜能尚不清楚。莫氏显微外科手术（MMS）已越来越多地用于治疗AC。
回顾所选原发性皮肤AC及其MMS治疗结果。
使用PubMed检索与原发性皮肤AC相关的文章进行文献综述。
接受MMS治疗的皮脂腺癌复发率和转移率分别为6.4%和3.7%。接受MMS治疗的原发性皮肤黏液癌复发率和转移率分别为9.6%和6.4%。MMS治疗后，微囊性AC的复发率为4.7%，未报告有转移。MMS治疗后，未报告外毛根鞘癌或汗腺癌的复发和转移。小汗腺汗孔癌报告有2例（4.2%）区域淋巴结转移，但无远处转移或局部复发。本文还综述了接受MMS治疗的鳞状小汗腺导管肿瘤、毛母质癌和螺旋腺癌。
ACs的罕见性以及缺乏治疗的对比数据使得难以对治疗做出确定性推荐。近期的大型病例系列和综述表明，MMS是一种治疗AC的有用且可能更优的方法，如果怀疑是原发性皮肤疾病，应考虑使用。
