- 期刊
頭皮骨肉瘤皮膚轉移－病例報告與文獻回顧
Cutaneous Metastasis of Osteosarcoma on the Scalp-A Case Report and Literature Review
摘要
骨肉瘤是最常見的原發性骨惡性腫瘤，其轉移型態多經由血液轉移。最常見的轉移器官為肺、骨骼與腎臟。回顧文獻，骨肉瘤的皮膚轉移相當罕見，僅有少數病案被報告過。在此，我們報告一位38歲男性在左下頷骨患有骨母細胞型骨肉瘤(osteoblastic type osteosarcoma)。患者接受根除性手術並持續門診追蹤。二年後患者因久咳不癒、胸痛放射到背部以及縱膈腔腫塊懷疑為肺部轉移。患者拒絕接受化療，因此建議放射線治療。然而懷疑肺部轉移七周後，患者頭皮呈現一個0.8乘以1公分大小的紅色疼痛堅實結節，外觀呈現如癰樣病灶。組織病理切片檢查發現其為轉移性骨肉瘤。據吾人所知，骨肉瘤的皮膚轉移極為罕見。這個病案告訴我們，雖然骨肉瘤的皮膚轉移相當罕見，倘若骨肉瘤的患者出現癰樣病灶，實不能等閒視之，仍應高度懷疑為骨肉瘤皮膚轉移。
關鍵字
無資料並列摘要
Osteosarcoma is the most common primary malignant neoplasm of the bone. The mode of metastasis is mainly hematogenous. The most frequent metastatic sites of osteosarcoma are the lung, bones and kidneys. After a review of the literature, cutaneous metastasis of osteosarcoma is an extremely rare event with only few reported cases. Hereby we present a 38-year-old man with a primary osteoblastic osteosarcoma in the left mandible. He received radical surgery and regular follow up. At 2 years, lung metastasis was suspected due to persistent cough, chest pain radiating to the back and mediastinal lung mass. Owing to refusing chemotherapy, radiation therapy was suggested. However, he developed a 0.8×1cm sized, painful, indurated erythematous carbuncle-like nodule on his scalp for 7 weeks after lung metastasis occurred. Histological examination of the lesion revealed metastatic osteosarcoma. To our knowledge, osteosarcoma metastasis to the skin is an extremely rare event and this case suggests that cutaneous metastasis should be highly suspected in a case of osteosarcoma with carbuncle-like skin nodule even though cutaneous metastasis is rare. Cutaneous metastasis in a patient of osteosarcoma should not be treated as a simple event.
延伸閱讀
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