Kato N, Yasukawa K, Onozuka T
Department of Dermatology and Clinical Research Institute, National Sapporo Hospital, Sapporo, Japan.
Am J Dermatopathol. 1998 Dec;20(6):571-7. doi: 10.1097/00000372-199812000-00005.
We report on a case of primary cutaneous adenoid cystic carcinoma with local recurrence and lymph node metastasis. The patient was a 52-year-old Japanese woman. The initial cutaneous lesion was a skin-colored, centrally elevated, thumb-sized nodule with hair loss on the scalp in the right side of the parietal region. Three and half years after the initial combined treatment consisting of surgery and irradiation, a recurrent nodule on the left side of the parietal region of the scalp and a lymph node metastasis with perinodal tissue involvement in the left retroauricular area were discovered. In the literature on primary cutaneous adenoid cystic carcinoma, the average age in the 37 cases reported, including the present case, is 58.1 years, and 23 of the patients are women. Thirty-two percent of the carcinomas (12 cases) occur on the scalp and 16% (6 cases) on the breast. The average size of the tumors in the 24 documented cases is 3.2 cm. The local recurrence rate is 51% (19 cases). Distant metastasis to the lungs and pleura are recorded in three cases. Lymph node metastasis is recorded only in two cases including the present case. Multiple modalities including surgery, irradiation, and chemotherapy should be used for this locally aggressive and potentially metastasizing carcinoma.
我们报告一例原发性皮肤腺样囊性癌伴局部复发和淋巴结转移的病例。患者为一名52岁的日本女性。最初的皮肤损害是一个肤色、中央隆起、拇指大小的结节，位于顶叶区域右侧头皮，伴有脱发。在最初采用手术和放疗的联合治疗三年半后，在头皮顶叶区域左侧发现一个复发性结节，在左耳后区域发现一个伴有淋巴结周围组织受累的淋巴结转移灶。在原发性皮肤腺样囊性癌的文献中，包括本病例在内报告的37例患者的平均年龄为58.1岁，其中23例为女性。32%的癌（12例）发生在头皮，16%（6例）发生在乳房。24例有记录的病例中肿瘤的平均大小为3.2厘米。局部复发率为51%（19例）。有3例记录有肺和胸膜的远处转移。仅包括本病例在内有2例记录有淋巴结转移。对于这种具有局部侵袭性且可能发生转移的癌，应采用包括手术、放疗和化疗在内的多种治疗方式。
