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Poroma: A 12-Year Experience in Taipei Veterans General Hospital and A Literatures Review

小汗腺瘤:台北榮民總醫院十二年治療經驗及文獻回顧

摘要


背景:小汗腺瘤是一種好發於四肢的遠端,從小汗腺產生的罕見良性皮膚腫瘤。然而臨床上小汗腺瘤卻和其他皮膚良性腫瘤非常相似,對於臨床醫生要憑藉肉眼從外觀上做出正確的診斷是有一定難度的。另外,小汗腺惡性腫瘤被認為是原發或100%從小汗腺瘤惡性轉變而來的,對此我們收集了過去十二年來對我們醫院在治療和追蹤的情況並加以討論。材料及方法:這是一篇收集台北榮民總醫院從西元2004年1至2015年5月間病人資料的回顧性分析。研究的總病人數為101位,其中包含了106顆小汗腺瘤。排除不明確的診斷,及對腫瘤大小、外觀和病歷描述不清的病例。結果:病人的平均年齡為68.4±16.4歲,而患者大部分分布於七十至九十歲的人口族群且男性占了多數。男女的比約為1.5:1。雖然小汗腺瘤多好發於患者的肢體末梢,但如果將體表分為三個部分(頭頸、軀幹和四肢),頭頸部則為單位面積發生率最高的區域。在我們追蹤的小汗腺瘤個案裡,腫瘤在經手術切除後的4.9年中並沒有局部復發的情形。淋巴癌所接受的化學藥物治療(8例)和白血病所接受的骨髓移植(2例)在我們的分析中被發現與小汗腺瘤的發生可能有關。此外,在這所有的個案當中並沒有發現有惡性轉變的情形。結論:小汗腺瘤是一種良性皮膚的腫瘤,尤其好發於較年長者的下肢。臨床上多以紅色豆狀結節來表現,但由於小汗腺瘤在與其他類似皮膚腫瘤比較上無明顯特徵,因此切確的診斷應經由組織病理學來分析。儘管有些作者主張小汗腺惡性腫瘤是由小汗腺瘤惡性轉變而來,但是在我們的追蹤研究中並沒有類似的案例。

關鍵字

無資料

並列摘要


Background: Poroma is a type of rare, benign skin tumor which originates from the sweat glands and is commonly seen on the distal aspect of the extremities. Grossly, the tumor is similar to other skin tumors, making the correct diagnosis a challenge for clinicians. Since porocarcinoma has been recognized de novo, or 100% transformed from a benign poroma, we have been interested in poromas in our institution for the past 12 years. Aim and Objectives: To understand the etiology, clinicopathological characteristics, and the possibility of malignant changes to this type of skin tumor, we present and discuss the patients in our experience, and review the available literature. Materials and Methods: We performed a retrospective analysis of the patients in the Taipei Veterans General Hospital, Taipei, Taiwan, from January 2004 to May 2015. For this study, 101 patients (106 poromas) were enrolled. Tumors with an uncertain diagnosis, or an incomplete description of tumor size or appearance in the medical records were excluded. Results: The patients had a mean age of 68.4 ± 16.4 years, the majority were in the 8th-9th decade of life, and were predominantly men (M:F = 1.5:1). Although poroma is described more commonly at the distal region of the extremities, in our study, head and neck cases account for the highest incidence per unit area, as we distinguish the total body surface into the head and neck, trunk, and extremities. After a mean follow-up of 4.9 years, no local, recurrent poromas were noted after surgical excision. Poly-chemotherapy of lymphoma (8 patients), and bone marrow transplantation of leukemia (2 patients) are found to associate with the occurrence of poroma. None of our cases had malignant transformations. Conclusion: Poroma, a kind of benign skin tumor, is more commonly found on the lower extremities of mid to old age men. Clinically, poroma has no obvious characteristics, and the exact diagnosis is thus made by histopathological analysis. Some authors suggest that porocarcinoma is transformed from poroma 100%, but there are no cases of this in our analysis.

並列關鍵字

poroma sweat gland tumor benign

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