Wollina U, Koch A, Schönlebe J, Tchernev G
Academic Teaching Hospital Dresden-Friedrichstadt, Department of Dermatology and Allergology; Institute of Pathology "Georg Schmorl"; Dresden, Germany; Medical Institute of Ministry of Interior (MVR), Department of Dermatology and Dermatologic Surgery, Sofia, Bulgaria.
Georgian Med News. 2017 Feb(263):7-10.
Non-melanoma skin cancer incidence is rising worldwide. The leading neoplasias are basal cell carcinoma and squamous cell carcinoma. We report on an 88-year-old female patient with a rapidly grown, symptomless, exophytic tumor of the supraclavicular area. Examination at the dermatology department has revealed a firm, exophytic, reddish tumor covered by crusts, about 4 cm in diameter and easily movable to the ground. The tumor was removed by delayed Mohs surgery (R0 resection). The resulting defect was closed by tissue expansion. Nodal metastases were ruled out by ultrasound. Histologic investigation revealed a biphasical nodular tumor composed of partly fibrous spindle cellular elements, partly myxoid and chondroid mesenchymal components with cellular atypia, atypical mitoses and focal necrosis. Some multinucleated tumor cells were noted. Trabecular and island-like solid epithelial tumor components demonstrated increased mitotic activity and cellular atypia. There was no vascular invasion. The diagnosis of a basaloid carcinosarcoma was confirmed. Basaloid carcinosarcoma is an extremely rare cutaneous neoplasia with less than 30 patients reported. Complete wide excision or Mohs surgery are the favored treatment options.
非黑色素瘤皮肤癌的发病率在全球范围内呈上升趋势。主要的肿瘤类型是基底细胞癌和鳞状细胞癌。我们报告了一名88岁女性患者,其锁骨上区域有一个生长迅速、无症状的外生性肿瘤。皮肤科检查发现一个质地坚硬、外生性、覆盖有痂皮的红色肿瘤,直径约4厘米,易于向周围移动。该肿瘤通过延迟性莫氏手术(R0切除)切除。所形成的缺损通过组织扩张进行闭合。超声检查排除了淋巴结转移。组织学检查显示为双相结节性肿瘤,由部分纤维性梭形细胞成分、部分黏液样和软骨样间充质成分组成,伴有细胞异型性、非典型有丝分裂和局灶性坏死。可见一些多核肿瘤细胞。小梁状和岛状实性上皮肿瘤成分显示有丝分裂活性增加和细胞异型性。未见血管侵犯。基底样癌肉瘤的诊断得以证实。基底样癌肉瘤是一种极其罕见的皮肤肿瘤,报告的患者不到30例。完整广泛切除或莫氏手术是首选的治疗方案。