Touré Sokona, Mallé Mahamadou
Faculté de Médecine et d'Odontostomatologie de Bamako, Bamako, Mali.
Service de Radiologie, Hôpital Régional de Gao, Gao, Mali.
Pan Afr Med J. 2019 May 28;33:62. doi: 10.11604/pamj.2019.33.62.16912. eCollection 2019.
Keloid is a benign fibroblastic tumor which is most often secondary to a scar, but it can occur spontaneously in a subject with black skin. We report the case of a 19-year old patient, electrician, presenting with giant right retroauricular mass evolving over two years. For some time, the patient has experienced a feeling of heaviness on the pavilion of the right ear. The lesion had manifested as a hard, pruritic, non-painful patch gradually increasing in size. The patient had received several topical and antiseptics treatments without any effect. He had a history of traumatic injury in the right retroauricular sulcus. A month after, pruritic hypertrophic scar occurred. Physical examination showed voluminous hard, fixed, retroauricular tumor (10 × 6 cm) with normal skin color, non-painful on movement (A). Its base was sessile. The remainder of the physical examination was normal. Ultrasound showed little vascularized skin tumor of the right retroauricular sulcus with more or less sharp margins, measuring 9 x 5 cm. Two diagnoses were suspected: post-traumatic keloid (most likely) and Darier Ferrand dermatofibrosarcoma. Biopsy was performed and histological examination showed keloid. The patient underwent intramarginal excision (B). The surgical specimens weighed 75 grams (C). The postoperative course was simple with disappearance of the feeling of heaviness.
瘢痕疙瘩是一种良性纤维母细胞瘤,最常见于继发于瘢痕之后,但也可在黑皮肤个体中自发出现。我们报告一例19岁男性电工患者,其右耳后巨大肿物已持续发展两年。一段时间以来,患者感到右耳郭有沉重感。病变最初表现为一个坚硬、瘙痒、无痛的斑片,逐渐增大。患者曾接受多种局部及抗感染治疗,但均无效。患者右耳后沟有创伤史,一个月后出现瘙痒性增生性瘢痕。体格检查发现耳后有一个巨大、坚硬、固定的肿物(10×6cm),皮肤颜色正常,活动时无痛(图A)。其基底为蒂状。其余体格检查正常。超声显示右耳后沟皮肤肿物血运较少,边界或多或少清晰,大小为9×5cm。怀疑有两种诊断:创伤后瘢痕疙瘩(最可能)和达里埃-费朗皮肤纤维肉瘤。进行了活检,组织学检查显示为瘢痕疙瘩。患者接受了边缘内切除(图B)。手术标本重75克(图C)。术后恢复顺利,沉重感消失。