Reingold I M, Smith B R, Graham J H
Am J Clin Pathol. 1978 May;69(5):561-5. doi: 10.1093/ajcp/69.5.561.
The rare lesion of epithelioma cuniculatum pedis may be recognized by the gross appearance of a slow-growing, bulky, "squashy," non-healing, exophytic mass of long duration on the sole, exuding foul-smelling purulent keratin debris from numerous sinuses, and biopsies showing extensive infiltrating plaques of keratinizing, well-formed, squamous epithelium forming walls for numerous sinuses filled with purulent material. The rarity of the lesion, the slow growth, and biopsies showing relatively benign-appearing well-differentiated squamous epithelium caused considerable diagnostic difficulty to clinicians and pathologists. The tumor failed to heal, extensively penetrated the soft tissues, ultimately destroyed the metatarsal bones, and invaded the skin of the dorsum of the fott. The lesion should be treated as a slow-growing, well-differentiated squamous cell carcinoma by wide local excision or by amputation when extensive growth causes deformity of the foot or penetration of the metatarsal bones.
肉眼可见足底有一个生长缓慢、体积较大、质地“软塌塌”、长期不愈合的外生性肿物，从多个窦道中渗出有恶臭的脓性角质碎屑；活检显示有广泛浸润的斑块，由角化良好的鳞状上皮形成众多充满脓性物质的窦道壁。该病变的罕见性、生长缓慢以及活检显示相对良性的高分化鳞状上皮，给临床医生和病理学家带来了相当大的诊断困难。肿瘤无法愈合，广泛侵犯软组织，最终破坏跖骨，并侵犯足背皮肤。当广泛生长导致足部畸形或跖骨受侵时，应将该病变视为生长缓慢、高分化的鳞状细胞癌，采用广泛局部切除或截肢治疗。
