Nath Neel Som, Gilmore Brian F, McCann Richard K, Mosca Paul J
School of Medicine, Duke University, Durham, North Carolina, USA.
Surgery, Duke University Medical Center, Durham, North Carolina, USA.
BMJ Case Rep. 2017 May 6;2017:bcr-2016-218932. doi: 10.1136/bcr-2016-218932.
Cutaneous squamous cell carcinoma (cSCC) currently affects over 700 000 patients per year in the USA alone, and its incidence continues to rise in recent years. A known risk factor for cSCC is chronic inflammation; a cSCC that develops at a site of chronic inflammation is known as Marjolin's ulcer. We present the case of a 76-year-old man with end-stage renal disease requiring chronic haemodialysis who developed an invasive cSCC at the cannulation site of an underlying arteriovenous (AV) fistula. In this instance, treatment with standard surgical excision or Mohs surgery would pose unique risks associated with injury to an otherwise functional AV fistula. Thus, the lesion was treated with electron beam radiation therapy, which offers a similar efficacy to surgery while minimising risk to the fistula. This resulted in a successful oncological outcome with no complications.
仅在美国，皮肤鳞状细胞癌（cSCC）目前每年就影响超过70万患者，且近年来其发病率持续上升。cSCC的一个已知风险因素是慢性炎症；在慢性炎症部位发生的cSCC被称为马乔林溃疡。我们报告了一例76岁患有终末期肾病需要长期血液透析的男性患者，其在潜在动静脉（AV）内瘘的插管部位发生了侵袭性cSCC。在这种情况下，采用标准手术切除或莫氏手术治疗会带来与损伤原本功能正常的AV内瘘相关的独特风险。因此，该病变采用电子束放射治疗，其疗效与手术相似，同时将对内瘘的风险降至最低。这带来了成功的肿瘤学结果，且无并发症。
