Zhang Fang, Bai Wenzhe, Sun Shuna, Li Na, Zhang Xiaojie
First Clinical Medical College, Shandong University of Traditional Chinese Medicine.
Department of Dermatology, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Shandong Provincial Hospital of Traditional Chinese Medicine, Jinan, Shandong, China.
Medicine (Baltimore). 2020 Jan;99(2):e18697. doi: 10.1097/MD.0000000000018697.
Giant porokeratosis is considered to be a variant of porokeratosis of Mibelli (PM) by some medical scholars. Porokeratosis can develop into several epidermal malignant tumors, such as Bowen disease and basal cell carcinoma, among which squamous cell carcinoma (SCC) is the most common.
The patient was a 53-year-old man who was admitted to our hospital due to postoperative recurrence and metastasis as SCC arising from giant PM in his left leg and foot.
The pathological results are porokeratosis and well-differentiated squamous cell carcinoma. Positron emission tomography and computed tomography results show the local recurrence of the tumor with multiple lymph node metastasis.
This patient was transferred to orthopedic surgery for amputation of the middle and lower left thigh.
Follow-up for 3 months has shown no recurrence after the surgery.
This report reminds us to pay close attention to the likelihood of giant porokeratosis. The physicians should explore all clinical possibilities to avoid misdiagnosis of this rare disease.Although the recurrence rate of SCC arising from giant PM is very low, the surgical resection region should be expanded appropriately such as the en-block resection.
一些医学学者认为巨大型汗孔角化病是米贝利汗孔角化病（PM）的一种变体。汗孔角化病可发展为多种表皮恶性肿瘤，如鲍温病和基底细胞癌，其中鳞状细胞癌（SCC）最为常见。
该患者为一名53岁男性，因左腿和足部巨大型PM引发的SCC术后复发和转移入院。
病理结果为汗孔角化病和高分化鳞状细胞癌。正电子发射断层扫描和计算机断层扫描结果显示肿瘤局部复发并伴有多处淋巴结转移。
该患者被转至骨科进行左大腿中下段截肢手术。
术后随访3个月未发现复发。
本报告提醒我们要密切关注巨大型汗孔角化病的可能性。医生应探索所有临床可能性，避免误诊这种罕见疾病。虽然巨大型PM引发的SCC复发率很低，但手术切除范围应适当扩大，如整块切除。
