Sun T B, Chien H F, Huang S F, Shih T T, Chen M T
Department of Surgery, National Taiwan University Hospital, Taipei, ROC.
J Formos Med Assoc. 1996 Jul;95(7):575-8.
A case of malignant chondroid syringoma on a foot with multiple bone metastases is presented. An 18-year-old male patient first noticed a protruding mass on the plantar surface of his right foot at 9 years of age. A sweat gland tumor of a benign nature was diagnosed and excised at that time. The tumor recurred three times during the 10 years after surgery and was finally diagnosed as malignant chondroid syringoma. Multiple bone metastases involving the calcaneus, talus and fibula of the lesion side were found after extensive radiologic survey. The patient underwent below-knee amputation with total removal of the fibula. However, pelvic bone metastasis developed 1 year after the amputation. He died of this disease due to brain and diffuse bony metastasis 36 months after the amputation. This is a rare case of malignant chondroid syringoma with a long history but ominous outcome. We recommend that sweat gland tumors be carefully examined and treated more radically when there is a suspicion of malignancy.
本文报告1例足部恶性软骨样汗腺螺旋瘤伴多发骨转移的病例。一名18岁男性患者9岁时首次发现右足跖面有一突出肿物。当时诊断为良性汗腺肿瘤并予以切除。术后10年内肿瘤复发3次，最终诊断为恶性软骨样汗腺螺旋瘤。经过全面的影像学检查，发现病变侧跟骨、距骨和腓骨出现多发骨转移。患者接受了膝下截肢术，并完整切除了腓骨。然而，截肢术后1年出现骨盆骨转移。截肢36个月后，患者因脑转移和弥漫性骨转移死于该病。这是一例罕见的恶性软骨样汗腺螺旋瘤，病史长但预后不佳。我们建议，当怀疑汗腺肿瘤为恶性时，应仔细检查并更积极地进行治疗。
