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腋窝原发性大汗腺癌前哨淋巴结活检:一例报告并文献复习

Sentinel lymph node biopsy of primary apocrine sweat gland carcinoma of the axilla: A case report and review of the literature.

作者信息

Sekine Chikako, Kawase Kazumi, Yoshida Kazuhiko

机构信息

Department of Surgery, The Jikei University School of Medicine Katsushika Medical Center, 6-41-2 Aoto, Katsushika Ward, Tokyo 125-8506, Japan; Department of Breast Surgery, International University of Health and Welfare, Narita Hospital, 852 Hatakeda Narita, Chiba 286-0124, Japan.

Department of Surgery, The Jikei University School of Medicine Katsushika Medical Center, 6-41-2 Aoto, Katsushika Ward, Tokyo 125-8506, Japan.

出版信息

Int J Surg Case Rep. 2020;77:122-125. doi: 10.1016/j.ijscr.2020.10.067. Epub 2020 Oct 28.

Abstract

INTRODUCTION

Primary apocrine sweat gland carcinoma (PASGC) is a rare subtype of sweat gland carcinoma, mostly occurring in the apocrine-dense regions such as the axilla, areola, and scalp.

PRESENTATION OF CASE

An 83-year-old woman developed a red elevating mass on her left axilla, without palpable axillary lymph nodes. Excision biopsy revealed that the tumor was PASGC. Additional wide resection and sentinel lymph node biopsy (SLNB) were performed without any adjuvant therapy. One year after the surgical procedure, the patient did not show any evidence of recurrence and axillary surgical complications.

DISCUSSION

As PASGC arising in the axilla can progress aggressively, differential diagnosis is essential. Previous reports have shown the usefulness of SLNB, but the axillary management for patients with clinically node negative PASGC has not been established because of its rarity. Especially in axillary cases, to identify the true sentinel lymph nodes is sometimes considered inaccurate because the lymphatic flow is complicated in the axilla.

CONCLUSION

Although SLNB in sweat gland carcinoma has believed safety and been performed, this is the first axillary PASGC case that was performed SLNB. Careful follow-up is needed.

摘要

引言

原发性大汗腺汗腺癌(PASGC)是汗腺癌的一种罕见亚型,主要发生于大汗腺密集分布的区域,如腋窝、乳晕和头皮。

病例介绍

一名83岁女性左侧腋窝出现一个红色隆起肿物,未触及腋窝淋巴结。切除活检显示肿瘤为PASGC。随后进行了扩大切除术和前哨淋巴结活检(SLNB),未进行任何辅助治疗。手术一年后,患者未出现任何复发迹象及腋窝手术并发症。

讨论

由于发生于腋窝的PASGC可能进展迅速,鉴别诊断至关重要。既往报道显示SLNB有一定作用,但由于PASGC罕见,临床上淋巴结阴性的PASGC患者的腋窝处理方法尚未确立。特别是在腋窝病例中,由于腋窝淋巴引流复杂,有时认为确定真正的前哨淋巴结不准确。

结论

尽管汗腺癌的SLNB被认为是安全的且已开展,但这是首例对腋窝PASGC进行SLNB的病例。需要进行密切随访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c1e/7649587/93231bfe0f59/gr1.jpg

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