Meléndez-Fernández Ana Paulina, Sánchez-Servín Alejandra, García-Ortega Dorian Yarih, Vega-González Ma Teresa, Caro-Sánchez Claudia H, Martínez-Said Hector
Skin and Soft Tissue Tumors Department, National Cancer Institute, Mexico City, Mexico.
National Cancer Institute, Mexico City, Mexico.
Int J Surg Case Rep. 2025 Aug 26;135:111852. doi: 10.1016/j.ijscr.2025.111852.
Malignant Adnexal Tumors of the Skin (MATS) are rare neoplasms that differentiate into adnexal structures, including hair follicles, sebaceous glands, and eccrine or apocrine glands. With an incidence of approximately 5 per 1 million person-years, there are no standardized guidelines for their diagnosis and treatment, leading to inconsistent outcomes. This study aims to describe the clinicopathological characteristics and outcomes in an oncology reference center over 15 years.
We retrospective analyzed 40 patients diagnosed with MATS at the National Cancer Institute of Mexico from 2005 to 2020. We collected clinical variables (age, gender, histological subtype, tumor site, and treatment) and pathological features (tumor size, lymphovascular invasion, perineural invasion, depth, necrosis, and margin status). We analyzed disease-free survival (DFS) and overall survival (OS).
The median age at diagnosis was 64 years, with a slight male predominance (55 %). Eccrine/apocrine tumors were the most common (57.5 %), followed by sebaceous (25 %) and follicular tumors (17.5 %). The head and neck were the most frequent sites (52.5 %). Surgical excision was performed in 95 % of patients, with adjuvant radiotherapy in 17.5 %. Lymph node metastases were present in 5 %, and no distant metastases were observed initially. Recurrence occurred in 17.5 % of patients. Median DFS was 45.3 months, and median OS was 48.9 months.
Radical excision remains the primary treatment for MATS, though adjuvant radiotherapy may be helpful in high-risk cases. Prospective studies are needed to establish treatment guidelines and to improve outcomes.
皮肤恶性附属器肿瘤（MATS）是一种罕见的肿瘤，可分化为附属器结构，包括毛囊、皮脂腺和小汗腺或大汗腺。其发病率约为每100万人年5例，目前尚无标准化的诊断和治疗指南，导致治疗结果不一致。本研究旨在描述一家肿瘤学参考中心15年来MATS的临床病理特征及治疗结果。
我们回顾性分析了2005年至2020年在墨西哥国家癌症研究所诊断为MATS的40例患者。我们收集了临床变量（年龄、性别、组织学亚型、肿瘤部位和治疗方法）和病理特征（肿瘤大小、淋巴管侵犯、神经周围侵犯、深度、坏死和切缘状态）。我们分析了无病生存期（DFS）和总生存期（OS）。
诊断时的中位年龄为64岁，男性略占优势（55%）。小汗腺/大汗腺肿瘤最为常见（57.5%），其次是皮脂腺肿瘤（25%）和毛囊肿瘤（17.5%）。头颈部是最常见的部位（52.5%）。95%的患者接受了手术切除，17.5%的患者接受了辅助放疗。5%的患者出现淋巴结转移，最初未观察到远处转移。17.5%的患者出现复发。中位DFS为45.3个月，中位OS为48.9个月。
根治性切除仍然是MATS的主要治疗方法，尽管辅助放疗可能对高危病例有帮助。需要进行前瞻性研究以建立治疗指南并改善治疗结果。
