Division of Dermatology, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, Tottori University, 36-1, Nishicho, Yonago, Tottori, 683-8503, Japan.
Curr Treat Options Oncol. 2022 May;23(5):736-748. doi: 10.1007/s11864-022-00971-3. Epub 2022 Mar 26.
Cutaneous adnexal malignancies include various types of malignant tumors that show differentiation of cutaneous appendages. They can be classified into sweat gland, hair follicle, and sebaceous gland differentiations. All types of cutaneous adnexal tumors are rare and standard treatment options based on valid evidence have not been established. Although prognosis differs depending on the type of cutaneous adnexal malignancy, surgery is the mainstay of treatment. In surgical treatment, an adequate surgical margin is unclear for wide local excision. Mohs micrographic is a better option than wide local excision in terms of margin control and cosmetic outcome because the face, head, and neck are favorable sites for some cutaneous adnexal malignancies. There has been no randomized trial of radiation therapy and chemotherapy for any cutaneous adnexal malignancies. Radiation therapy should be considered if the tumor cannot be removed surgically. Chemotherapy is one of the options for metastatic cases in some types of cutaneous adnexal malignancies, but evidence of the effectiveness of chemotherapy is lacking. Recent studies have revealed genetic mutations in this field, and target therapy and immunotherapy may be promising treatment options for unresectable cutaneous adnexal malignancies in the future.
皮肤附属器恶性肿瘤包括各种分化为皮肤附属器的恶性肿瘤。它们可以分为汗腺、毛囊和皮脂腺分化。所有类型的皮肤附属器肿瘤都很少见，并且尚未建立基于有效证据的标准治疗选择。尽管预后因皮肤附属器恶性肿瘤的类型而异，但手术是主要的治疗方法。在手术治疗中，广泛局部切除的手术切缘尚不清楚。Mohs 显微外科手术在切缘控制和美容效果方面优于广泛局部切除，因为面部、头部和颈部是某些皮肤附属器恶性肿瘤的有利部位。对于任何皮肤附属器恶性肿瘤，都没有关于放疗和化疗的随机试验。如果肿瘤不能通过手术切除，应考虑放疗。对于某些类型的皮肤附属器恶性肿瘤，化疗是转移性病例的选择之一，但缺乏化疗有效性的证据。最近的研究揭示了该领域的基因突变，针对这些突变的靶向治疗和免疫疗法可能是未来不可切除的皮肤附属器恶性肿瘤有希望的治疗选择。
