发生于内分泌螺旋腺瘤并有转移的癌肉瘤:病例报告及文献复习。

IF 1.1 4区 医学 Q3 DERMATOLOGY
Lisa M Marinelli, Jared M Orrock, Andrew L Folpe
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引用次数: 0

摘要

汗腺螺旋腺瘤是良性的汗腺肿瘤,很少发生恶性转化。由汗腺螺旋腺瘤引起的癌肉瘤极为罕见。41岁男性,颈部/肩部肿块迅速增大,进行性麻木、痉挛和虚弱。进一步检查发现硬膜外肿块伴脊髓压迫。两个肿块均被切除,主要表现为高级别骨肉瘤的形态学特征,明显的恶性梭形细胞产生蕾丝样骨样。然而,来自上背部肿块的单个切片包含约2mm的常规内分泌螺旋腺瘤灶,邻近的小灶具有低分化非小细胞癌的特征。最终诊断为高级别癌肉瘤伴异源骨肉瘤分化,起源于先前存在的内分泌螺旋腺瘤,并转移至T4-5硬膜外区。患者经历了脊柱肿块的快速再生并接受了放疗,但在2个月的随访中出现了不可切除的转移性疾病。我们描述了据我们所知的第21例由内分泌螺旋腺瘤引起的癌肉瘤,模仿转移性骨肉瘤。意识到这种非常罕见的实体,仔细取样,密切的显微镜检查,并在选定的病例中,辅助免疫组织化学是做出这种具有挑战性的诊断的关键。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Carcinosarcoma Arising in an Eccrine Spiradenoma and Presenting With Metastasis: Case Report and Literature Review.

Eccrine spiradenomas are benign sweat gland neoplasms that rarely undergo malignant transformation. Carcinosarcoma arising from an eccrine spiradenoma is exceptionally rare. A 41-year-old male presented with a rapidly growing neck/shoulder mass, progressive numbness, spasticity, and weakness. Further workup additionally revealed an epidural mass with spinal cord compression. Both masses were excised and predominantly showed morphologic features of high-grade osteosarcoma, with overtly malignant spindled cells producing lace-like osteoid. However, a single section from the upper back mass contained a roughly 2 mm focus of conventional eccrine spiradenoma, with an adjacent small focus having features of a poorly differentiated non-small cell carcinoma. The final diagnosis was that of a high-grade carcinosarcoma with heterologous osteosarcomatous differentiation, arising from a pre-existing eccrine spiradenoma, with metastasis to the T4-5 epidural region. The patient experienced rapid regrowth of the spinal mass and underwent radiotherapy but had unresectable metastatic disease at 2 months follow-up. We describe what is to our knowledge only the 21st example of carcinosarcoma arising from eccrine spiradenoma, mimicking metastatic osteosarcoma. Awareness of this very rare entity, careful sampling, close microscopic examination, and, in selected cases, ancillary immunohistochemistry are the keys to making this challenging diagnosis.

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来源期刊
CiteScore
3.20
自引率
5.90%
发文量
174
审稿时长
3-8 weeks
期刊介绍: Journal of Cutaneous Pathology publishes manuscripts broadly relevant to diseases of the skin and mucosae, with the aims of advancing scientific knowledge regarding dermatopathology and enhancing the communication between clinical practitioners and research scientists. Original scientific manuscripts on diagnostic and experimental cutaneous pathology are especially desirable. Timely, pertinent review articles also will be given high priority. Manuscripts based on light, fluorescence, and electron microscopy, histochemistry, immunology, molecular biology, and genetics, as well as allied sciences, are all welcome, provided their principal focus is on cutaneous pathology. Publication time will be kept as short as possible, ensuring that articles will be quickly available to all interested in this speciality.
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