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应用简单皮瓣修复乳腺癌术后放疗所致皮肤鳞状细胞癌患者的大面积缺损:1例报告

Application of a simple skin flap to repair large defects in a patient with radiotherapy‑induced skin squamous cell carcinoma after breast cancer surgery: A case report.

作者信息

Teng Yue-Yue, Huang Sheng-Chao, Qiu Pu, Yan Ze-Ming, Chen Chun-Yan, Yu Miao, Liang Zhong-Zeng, Li Jian-Wen, Zhang Yuan-Qi

机构信息

The First School of Clinical Medicine, Guangdong Medical University, Zhanjiang, Guangdong 524000, P.R. China.

Department of Vascular-Thyroid-Breast Surgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong 524000, P.R. China.

出版信息

Oncol Lett. 2025 Apr 14;29(6):297. doi: 10.3892/ol.2025.15043. eCollection 2025 Jun.

DOI:10.3892/ol.2025.15043
PMID:40276083
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12018794/
Abstract

Radiotherapy is a leading treatment intervention for cancer and has been shown to improve the prognosis of patients with malignant tumors. However, there are several side effects associated with radiotherapy that require attention. The present case study describes the case of a patient who underwent breast-conserving surgery after receiving a diagnosis of right-sided breast cancer, following which they received conventional radiation therapy. A skin nodule was found on the right side of the breast 3 years later, which was pathologically confirmed to be a highly differentiated skin squamous cell carcinoma after surgical local excision. The patient presented with poor skin healing 2 months after the operation, and a myocutaneous flap of the descending branches of the thoracodorsal vessels was used to repair the defect and improve the breast shape. Although skin cancer induced by radiotherapy is relatively rare, physicians should remain cautious when treating skin injuries after radiotherapy, and recovery should be closely monitored. For patients with skin nodules after radiotherapy, a biopsy should be performed as early as possible to clarify the diagnosis and to develop appropriate treatment programs. For such skin cancer patients who have received radiotherapy in the past, it is necessary to consider the potential radiotherapy-related skin injuries they may have suffered after previous radiotherapy, the skin flap should be comprehensively evaluated before the operation and an appropriate surgical method should be selected to reduce the necessity of a second operation.

摘要

放射治疗是癌症的主要治疗手段之一,已被证明可改善恶性肿瘤患者的预后。然而,放射治疗存在一些需要关注的副作用。本病例研究描述了一名患者的情况,该患者在被诊断为右侧乳腺癌后接受了保乳手术,随后接受了传统放射治疗。3年后在右侧乳房发现一个皮肤结节,手术局部切除后经病理证实为高分化皮肤鳞状细胞癌。患者术后2个月出现皮肤愈合不良,采用胸背血管降支肌皮瓣修复缺损并改善乳房外形。虽然放射治疗诱发的皮肤癌相对少见,但医生在处理放射治疗后的皮肤损伤时应保持谨慎,并密切监测恢复情况。对于放射治疗后出现皮肤结节的患者,应尽早进行活检以明确诊断并制定合适的治疗方案。对于既往接受过放射治疗的此类皮肤癌患者,有必要考虑其既往放射治疗后可能遭受的潜在放射治疗相关皮肤损伤,术前应全面评估皮瓣情况并选择合适的手术方式,以减少二次手术的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7f1/12018794/fd771c31fe39/ol-29-06-15043-g06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7f1/12018794/c85fb5715fdb/ol-29-06-15043-g00.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7f1/12018794/43d0dcd16aa6/ol-29-06-15043-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7f1/12018794/ec863152e54c/ol-29-06-15043-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7f1/12018794/13415d2bd815/ol-29-06-15043-g03.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7f1/12018794/6e43aaa855a0/ol-29-06-15043-g05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7f1/12018794/fd771c31fe39/ol-29-06-15043-g06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7f1/12018794/c85fb5715fdb/ol-29-06-15043-g00.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7f1/12018794/43d0dcd16aa6/ol-29-06-15043-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7f1/12018794/ec863152e54c/ol-29-06-15043-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7f1/12018794/13415d2bd815/ol-29-06-15043-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7f1/12018794/4fc545a17941/ol-29-06-15043-g04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7f1/12018794/6e43aaa855a0/ol-29-06-15043-g05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7f1/12018794/fd771c31fe39/ol-29-06-15043-g06.jpg

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本文引用的文献

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Radiation-induced skin reactions: oxidative damage mechanism and antioxidant protection.辐射诱导的皮肤反应:氧化损伤机制与抗氧化保护
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