足部恶性软骨瘤1例报告

M. Masten
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摘要

背景:本病例报告是关于一种非常罕见的肿瘤——恶性软骨样汗管瘤。这篇文章的目的是回顾该病例以及目前关于皮肤附件肿瘤的文献。病例介绍:患者是一名73岁的高加索女性,既往有结肠癌和乳腺癌癌症治疗史,右脚内侧有2年缓慢生长、疼痛的皮肤病变史。患者因右脚疼痛向初级保健医生(PCP)就诊,右脚疼痛可归因于拇囊炎。初级保健医生鼓励患者去看足科医生。在介绍给足科医生后,患者进行了右脚活检。病理报告显示混合性恶性软骨样脊髓瘤,边缘呈阳性。建议再次切除以确保完全切除。患者接受了肿瘤外科手术,随后接受了右脚肿块的完全切除。在术后7个月的最后一次就诊时,患者的伤口愈合和手术伤口的持续引流仍然存在问题。讨论:该病例与目前关于皮肤附件肿瘤的许多文献不同,因为它是一种极为罕见的足部恶性软骨样汗管瘤。在类似的地方,只有三个其他已发表的类似恶性肿瘤的病例报告。由于案例的独特性,本案例研究非常重要。这个病例提醒我们,活检在治疗前诊断的重要性,因为这种罕见的软组织肿瘤不太可能在没有活检的情况下被诊断出来。结论:该病例的教训是,对未知肿块进行活检,并与特定专家进行随访是很重要的。
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Malignant Chondroid Syringoma of the Foot – A Case Report
Background: This case report is about a very rare tumor – a malignant chondroid syringoma. The objective of this piece is to review both the case presented along with the current literature on cutaneous adnexal tumors. Case Presentation: The patient is a 73-year-old Caucasian female with a past medical history of treated colon and breast cancer who presented with a 2-year history of a slow-growing, painful cutaneous lesion on the medial aspect of her right foot. The patient presented to her primary care physician (PCP) for right foot pain, which was attributed to bunions. The PCP encouraged the patient to see a podiatrist for this issue. Upon presentation to the podiatrist, the patient had a right foot biopsy. The pathology report showed a mixed malignant chondroid syringoma with positive margins. A re-excision to ensure complete removal was recommended. The patient presented to surgical oncology and subsequently she underwent complete excision of the right foot mass. At the time of her last visit, 7 months postoperatively, the patient continued to have issues with wound healing and continuous drainage of her surgical wound. Discussion: This case differs from much of the current literature surrounding cutaneous adnexal tumors as it is a malignant chondroid syringoma of the foot, which is exceedingly rare. There are only three other published case reports of similar malignancies in similar places. This case study is important due to the uniqueness of the case. This case serves as a reminder of the importance of biopsy for diagnosis prior to management, as it is unlikely that such rare soft tissue tumors can be diagnosed without biopsy. Conclusion: The take away lesson of the case is that it is important to biopsy unknown masses, and to have follow up with specific specialists.
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