From the Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul.
Department of Plastic and Reconstructive Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Ann Plast Surg. 2024 May 1;92(5):575-579. doi: 10.1097/SAP.0000000000003880. Epub 2024 Mar 26.
Epidermal cysts are among the most common benign subcutaneous tumors. However, malignant transformation of benign epidermal cysts into squamous carcinomas has been reported. Owing to its low incidence rate, the clinical and pathological features of this condition are not well understood. This study aimed to analyze the clinical and pathological characteristics of the malignant transformation of epidermal cysts, which could suggest an appropriate treatment strategy. We conducted a retrospective study of 9 patients diagnosed with squamous cell carcinoma arising from epidermal cysts. All patients underwent surgical excision, and clinical information regarding patient demographics, tumor characteristics, treatment, and outcomes was analyzed. The average age at diagnosis was 57.3 years, with an average latency period of 15.4 years. Five patients had undergone prior cyst excision or drainage, with an average of 2.3 episodes of recurrence. Surgical excision was the primary treatment in all cases, and 2 patients with margin involvement at the final pathology underwent re-excision with additional resection margins. No recurrence was observed during the follow-up period. Four patients had immune dysregulation due to an underlying chronic kidney disease or cancer. Our study emphasizes the need for increased awareness of squamous cell carcinoma arising from epidermal cysts in patients with a history of cyst existence or recurrence, especially those with immune deficiencies. We expect these findings to contribute to early suspicion of malignant transformation and guide adequate clinical decision-making.
表皮囊肿是最常见的良性皮下肿瘤之一。然而，良性表皮囊肿恶变为鳞状细胞癌已有报道。由于其发病率低，这种情况的临床和病理特征尚未被很好地理解。本研究旨在分析表皮囊肿恶性转化的临床和病理特征，这可能提示出适当的治疗策略。我们对 9 例诊断为表皮囊肿来源的鳞状细胞癌患者进行了回顾性研究。所有患者均行手术切除，并分析了患者人口统计学、肿瘤特征、治疗和结局的临床信息。诊断时的平均年龄为 57.3 岁，潜伏期平均为 15.4 年。5 例患者曾行囊肿切除术或引流术，复发平均为 2.3 次。所有病例均行手术切除，2 例最终病理有边缘累及的患者行再次切除术并扩大切除边缘。随访期间无复发。4 例患者因慢性肾脏病或癌症存在免疫失调。本研究强调了在有囊肿存在或复发史的患者中，尤其是存在免疫缺陷的患者中，对表皮囊肿来源的鳞状细胞癌提高认识的必要性。我们希望这些发现有助于早期怀疑恶性转化，并指导适当的临床决策。
