微囊腫性附屬器癌以
Mohs Micrographic 手術治療之經
驗
A case report of microcystic adnexal
carcinoma treated with Mohs micrographic
surgery
王國憲
Chu PN;Cheng KL;Wang KH;Lin YH;Lee WR
摘要 微囊腫性附屬器癌乃是罕見的皮膚附屬器惡性腫瘤，其特色為局部侵犯的表現。 病理及免疫組織病理上的發現，可以找到混合汗管和毛囊的分化。至今，Mohs 顯微定位手術對此腫瘤比傳統式的廣泛的切除法有更加良好的療效。我們報告一 位 66 歲的男性病人在靠近左側的鼻唇區域有一緩慢擴大的白色班塊至少 20 年之 久。診斷性的病理切片表現有浸潤相當深地索狀以及鏈狀的似汗管以及似毛囊分 化的腫瘤細胞被包覆在硬化的間質當中，符合微囊腫性附屬器癌的診斷。病人隨 後即接受 Mohs 顯微定位手術治療。本例為臺灣第一個被報導接受此治療的病例。 AbstractMicrocystic adnexal carcinoma is a rare cutaneous appendageal malignancy, which is characterized by local aggressiveness. Histopathologically and immuno-histopathologically, the tumor reveals mixed eccrine and pilar differentiation. To date, Mohs micrographic surgery providcs a more effective therapy and better outcome than traditional wide excision. We report a 66-year-old male with a slowly growing whitish indurated plaque approaching his left nasolabial area for at least 20 years. A diagnostic biopsy showed deeply infiltrating cords and strands of tumor cells with eccrine-like and pilar-like differentiation surrounded by a sclerotic stroma. Microcystic adenxal carcinoma was diagnosed and Mohs micrographic surgery was performed consequently. This is the first reported case treated with Mohs micrographic surgery in Taiwan.
