Department of Plastic and Cosmetic Surgery, Xiangya Hospital, Central South University, Changsha 410008.
Department of Plastic Surgery, Xi'an International Medical Center Hospital, Xi'an 710100, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2022 Mar 28;47(3):384-389. doi: 10.11817/j.issn.1672-7347.2022.200925.
Nevus-like basal cell carcinoma syndrome (NBCCS) is a rare autosomal dominant disease characterized by the occurrence of multiple maxillofacial keratocysts, basal cell carcinoma, child medulloblastoma, and various skeletal and soft tissue dysplasia. In 2020, a patient with NBCCS dominated by facial basal cell carcinoma was admitted to Xiangya Hospital of Central South University. The patient was an elderly woman. Ten years ago, the systemic mass appeared, especially on the face, but it was not treated. Later, these masses gradually increased in volume and number, and showed invasive properties. The nasal mass was broken and suppurated, seriously affecting the patient's life quality. The patient came to the hospital to improve the symptoms. and were cultured in the patient's nasal secretions. Nasal sinus enhanced MRI showed that the subcutaneous soft tissue of the right cheek and the anterolateral mucosa of the left nasal cavity were invaded, indicating multiple malignant skin lesions. After admission, local anesthesia was performed and some masses were removed. Pathological examination of the mass showed basal cell carcinoma. After general anesthesia, multiple masses were resected. The postoperative pathological examination showed that multiple basal cell carcinoma invaded the deep dermis near subcutaneous fat layer. Combined with the results of clinical and immunohistochemical examination, the patient was diagnosed as NBCCS. There were no clear tumor thrombus in the vessel and no nerve invasion. No recurrence or new tumor was found after 1 year follow-up. The incidence rate of NBCCS is low and clinical symptoms are different. The patient's life quality is poor and the patient needs long-term individualized treatment.
结节性基底细胞癌综合征(NBCCS)是一种罕见的常染色体显性遗传病,其特征为多发性颌面部角化囊肿、基底细胞癌、儿童髓母细胞瘤以及多种骨骼和软组织发育不良。2020 年,一名以面部基底细胞癌为主的 NBCCS 患者入住中南大学湘雅医院。该患者为老年女性,10 年前全身多处出现肿块,尤以面部明显,但未予诊治。此后,这些肿块逐渐增大、增多,并呈侵袭性生长,鼻部肿块破溃、流脓,严重影响患者生活质量。患者为改善症状来院就诊,于患者鼻部分泌物中培养出。鼻窦增强 MRI 提示右侧面颊部皮下软组织及左侧鼻腔前外侧壁受侵,考虑为多发性恶性皮肤病变。入院后行局部麻醉下部分肿块切除术,肿块病理检查示基底细胞癌。全麻下行多处肿块切除术,术后病理检查示多发基底细胞癌侵犯近皮下脂肪层的深部真皮。结合临床及免疫组化检查结果,诊断为 NBCCS。血管内未见明确瘤栓,未见神经侵犯。术后 1 年随访未发现复发及新发肿瘤。NBCCS 发病率低,临床表现多样,患者生活质量差,需要长期个体化治疗。