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你对一个不寻常的腋窝肿块怎么看?

What do you think of an unusual axillary mass?

作者信息

Benzzi Hafsa, Askour Majda, Elouazani Afaf, Bouaddi Mouna, Hassam Badreddine, Saidi Amar

机构信息

Dermatology Department, Mohamed V University, Rabat, Morocco.

Pathology Center United Nations, Rabat, Morocco.

出版信息

Pan Afr Med J. 2017 Dec 13;28:309. doi: 10.11604/pamj.2017.28.309.3092. eCollection 2017.

Abstract

Skin apocrine carcinoma is a rare malgnancy of epidermal adnexa, most frequent in axillary seat, where apocrine sweat gland are abundant, the neoplasm can arise in groin, anogenital, lips, eyelid, characterized by a plate or surface area of nodules hummocky. Etiology and incidence are not known. The prognosis is influenced by the risk of locoregional recurrence and metastatic evolution. We describe the case of 61-year-old man who presented a left axillary slow-growing mass since 2 years ago. The cutaneous biopsy objectified an apocrine adenocarcinoma. The paraclinic exams performed to detect primary breast were tumor negative, first step before confirming the diagnosis. Standard treatment is surgical excision with margins of 2 to 3cm for local tumor, for apocrine adenocarcinoma regional lymph node dissection if nodes were clinically positive is wide surgical excision. This kind of tumour is chemoresistant. In this case, adjuvant chemotherapy was indicated, before surgery to reduce tumoral volume. This case illustrates the importance clinicopathological correlation of skin cancer, particularly apocrine one. Clinical particularity and careful analyses histology helps diagnosis approach.

摘要

皮肤大汗腺癌是一种罕见的表皮附属器恶性肿瘤,最常见于腋窝部位,此处大汗腺丰富,肿瘤也可发生于腹股沟、肛门生殖器、唇部、眼睑,其特征为呈板块状或结节状隆起的表面积。病因及发病率尚不清楚。预后受局部区域复发和转移进展风险的影响。我们描述了一名61岁男性的病例,该患者自2年前起左侧腋窝出现一个生长缓慢的肿块。皮肤活检确诊为大汗腺癌。为检测原发性乳腺癌而进行的辅助检查结果为肿瘤阴性,这是确诊前的第一步。标准治疗方法是对局部肿瘤进行切缘2至3厘米的手术切除,对于大汗腺癌,如果临床检查发现淋巴结阳性,则进行区域淋巴结清扫,即广泛手术切除。这种肿瘤对化疗耐药。在本病例中,在手术前进行辅助化疗以缩小肿瘤体积。该病例说明了皮肤癌,尤其是大汗腺癌临床病理相关性的重要性。临床特殊性和仔细的组织学分析有助于诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9de3/5927561/ebb45d7786d2/PAMJ-28-309-g001.jpg

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