Mizuta Haruki, Hatano Takaharu, Fujikawa Heishiro, Motomura Hisashi
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine Osaka City University, Osaka, Japan.
J Plast Reconstr Surg. 2022 Dec 6;2(2):53-57. doi: 10.53045/jprs.2022-0009. eCollection 2023 Apr 27.
A 67-year-old man had a tumor on his right cheek. It was resected 15 years earlier but recurred 1 year before his first visit. He had a red papule on his right cheek and subcutaneous induration in the right preauricular area. A right cheek biopsy revealed a mucinous carcinoma. The positron emission tomography-computed tomography showed accumulation only in the right cheek and parotid gland lymph node; therefore, we diagnosed primary cutaneous mucinous carcinoma. Sentinel lymphoscintigraphy showed accumulation of parotid gland and level II lymph node. He underwent extended resection and sentinel-node biopsy. Both lymph nodes were metastatic, requiring the appropriate range of neck dissection. There were no recurrence and metastasis postoperatively. There is no effective treatment when distant metastasis occurs, and the prognosis is poor. Therefore, it is important to prevent metastasis. However, positron emission tomography-computed tomography could not reveal early micrometastases. Therefore, a sentinel-node biopsy can be key to early detection and treatment.
一名67岁男性右侧脸颊有一肿瘤。该肿瘤于15年前切除,但在他首次就诊前1年复发。他右侧脸颊有一红色丘疹,右耳前区域有皮下硬结。右侧脸颊活检显示为黏液癌。正电子发射断层扫描-计算机断层扫描显示仅右侧脸颊和腮腺淋巴结有放射性聚集;因此,我们诊断为原发性皮肤黏液癌。前哨淋巴结闪烁显像显示腮腺和Ⅱ级淋巴结有放射性聚集。他接受了扩大切除术和前哨淋巴结活检。两个淋巴结均有转移,需要进行适当范围的颈部清扫术。术后无复发和转移。发生远处转移时没有有效的治疗方法,预后较差。因此,预防转移很重要。然而,正电子发射断层扫描-计算机断层扫描无法发现早期微转移。因此,前哨淋巴结活检可能是早期发现和治疗的关键。