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伴有嗜酸性粒细胞增多的血管淋巴样增生:降低复发率的新概念。

Angiolymphoid Hyperplasia With Eosinophilia: New Concept to Lower Recurrence.

作者信息

Labib Amir, Estawrow Mina

机构信息

Plastic Surgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

出版信息

J Craniofac Surg. 2019 Jul;30(5):e386-e388. doi: 10.1097/SCS.0000000000005224.

Abstract

Angiolymphoid Hyperplasia with Eosinophilia (AHLE) is a rare benign vascular disorder of unknown etiology. While World Health Organization recognizes it as a benign neoplasm, its progressive nature and high recurrence rate are consistent with being a locally malignant tumor. It may present as solitary or multiple nodules with more predilection to head and neck region, especially auricular area. Despite variety of available treatment options, high recurrence rate remains a compelling issue. The spectrum of these treatment modalities includes topical or systemic steroids use, intralesional injection of certain materials such as Bleomycin, Vinblastine or interferon, or even surgical excision.In our study, the authors present a case of middle-aged female with recurrent AHLE in left concha and preauricular region. Excision of the lesion with 4 mm of the normal surrounding skin, preserving auricular cartilage, was done while the resultant defect was covered by grafted Temporoparietal Fascia Flap. Our 1-year follow-up period showed aesthetically accepted outcome with no recurrence.The authors hypothesize that treating AHLE as a locally malignant tumor by excising the lesion with 4 mm safety margin decreases recurrence rates. Moreover, reconstruction by grafted temporoparietal fascia flap achieves a reasonable aesthetic outcome with minimal donor site morbidity.

摘要

嗜酸性粒细胞增多性血管淋巴样增生(AHLE)是一种病因不明的罕见良性血管疾病。虽然世界卫生组织将其认定为良性肿瘤,但其进行性本质和高复发率与局部恶性肿瘤相符。它可表现为孤立或多发结节,更易发生于头颈部区域,尤其是耳部。尽管有多种可用的治疗选择,但高复发率仍是一个突出问题。这些治疗方式包括局部或全身使用类固醇、瘤内注射某些物质(如博来霉素、长春碱或干扰素),甚至手术切除。在我们的研究中,作者报告了一例中年女性,其左耳甲和耳前区域反复出现AHLE。在保留耳软骨的情况下,切除病变及周围4毫米的正常皮肤,然后用移植的颞顶筋膜瓣覆盖由此产生的缺损。我们1年的随访期显示,美学效果可接受且无复发。作者推测,将AHLE作为局部恶性肿瘤,以4毫米安全切缘切除病变可降低复发率。此外,用移植的颞顶筋膜瓣进行重建可获得合理的美学效果,且供区并发症最少。

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