Grauwin M Y, Mane I, Cartel J L
Institut de Léprologie Appliquée, Dakar, Sénégal.
Acta Leprol. 1996;10(2):101-4.
Between 1983 and 1994, 66 Senegalese leprosy patients were seen for cauliflower growths developed in chronic plantar ulcer (CPU), (2 patients had each 2 tumors). 68 biopsies for pathological examination were taken: the diagnosis of squamous cell carcinoma was effectively made in 39 cases (38 patients) and that of pseudo-epitheliomatous hyperplasia in the remaining 29 cases (28 patients). The mean annual frequency of cauliflower growths was 0.45 per 100 CPU. Among these tumors, the percentage of carcinoma was 57%. Of the 38 patients with a carcinoma, 5 refused amputation and all of them died. The 33 others were amputated and of these 8 died as a direct result of their carcinoma (24%). In the case of the 28 patients with hyperplasia, amputation was carried out on 18 patients and local excision on 10. In the months following the operation 8 recurrences were observed in 10 of the patients on whom excision had been carried out. These recurrences were treated by amputation. This gives a total of 93% of amputations in the cases of hyperplasia. These facts lead as to conclude that at least in countries where pathological examination is not available below knee amputation is the most reasonable action to take in the proliferative tumors developed on a CPU.
1983年至1994年间，66例塞内加尔麻风病患者因慢性足底溃疡（CPU）处出现菜花样肿物前来就诊（2例患者各有2个肿物）。共进行了68次病理活检：39例（38名患者）确诊为鳞状细胞癌，其余29例（28名患者）为假上皮瘤样增生。菜花样肿物的年平均发生率为每100例CPU中有0.45例。在这些肿物中，癌的比例为57%。38例癌患者中，5例拒绝截肢，全部死亡。其余33例接受了截肢手术，其中8例因癌直接死亡（24%）。28例增生患者中，18例行截肢手术，10例行局部切除。术后数月，接受切除手术的10例患者中有8例复发。这些复发患者接受了截肢治疗。增生患者中截肢手术的比例总计达93%。这些事实让我们得出结论，至少在无法进行病理检查的国家，对于CPU上出现的增生性肿瘤，膝下截肢是最合理的处理措施。
