Giant Keratoacanthoma Development after Surgical Debridements on Chronic Leg Wounds-Case Report and Review of the Literature

小腿慢性傷口清創後發展大型棘皮瘤－病例報告及文獻回顧

官振翔(Chen-Hsiang Kuan) ； 謝榮賢(Jung-Hsien Hsieh) ； 簡雄飛(Hsiung-Fei Chien) ； 陳明庭(Ming-Ting Chen)

《臺灣整形外科醫學會雜誌》 21卷3期 (2012/09) Pp. 250-256

https://doi.org/10.7096/TJTSPS.201209.0250

摘要

背景：棘皮瘤被視為由毛囊皮脂腺發展而來的皮膚低惡性度腫瘤。文獻上曾被提出有許多因子和其發展有強度關聯性，例如暴露紫外光線，遺傳因子，化學致癌物，放射線照射，及外傷等。目的及目標：我們提出一罕見病例：下肢外傷後發展成大型棘皮瘤。材料及方法：此五十六歲女性因外傷之下肢慢性傷口，在經過手術清創後，發展成大型棘皮瘤，我們以積極廣泛性腫瘤切除及植皮治療之。結果：病人術後恢復良好，並且門診追蹤三年並無局部復發。結論：對於大型棘皮瘤，手術切除仍是治療首選。我們的病例提出棘皮瘤可能在雙下肢慢性傷口併手術清創後發展出來。臨床醫師應該要瞭解熟悉此病灶之表現及適當治療。

並列摘要

Background: Keratoacanthomas are considered to be low-grade cutaneous malignancies arising from the epithelium of the pilose-baceous unit. Many factors have a strong association in development including ultraviolet light exposure, genetic factors, chemical carcinogens, radiation, and trauma. Aim and Objectives: We report a rare case of giant KA in the lower extremity resulting from trauma. Materials and Methods: We describe a 56-year-old woman with a giant keratoacanthoma, measuring 5.5×4cm, developing in a lower leg chronic ulcer after surgical debridements. Wide excision of the tumor and skin grafts were applied to the defect. Results: The patient healed well and regularly followed up for three years without local tumor recurrence. Conclusion: Surgical excision remains the treatment of choice for giant keratoacanthomas. Our rare case demonstrates that keratoacanthomas could develop in lower extremities after chronic ulcers had repeated traumatized as surgical debridements. Physicians should be familiar with the clinical features and appropriate treatment of keratoacanthomas. (J Taiwan Soc of Plast Surg 2012;21:250~256)

並列關鍵字

giant keratoacanthoma ； lower leg ； surgical debridements ； trauma