Sebaceous Carcinoma of the Scalp - A Case Report and Literature Review

後頭皮部皮脂腺癌－病例報告及文獻回顧

翁日升(Jih-Sen Wong) ； 許宏達(Honda Hsu) ； 鄭立福(Li-Fu Cheng) ； 吳孟熹(Meng-Si Wu) ； 李俊達(Jiunn Tat Lee)

《臺灣整形外科醫學會雜誌》 27卷3期 (2018/09) Pp. 180-187

摘要

Background: Sebaceous carcinoma is a rare malignant skin cancer that originates in the sebaceous gland. It is a locally aggressive tumor and has metastatic potential. Sebaceous carcinoma can be classified into two groups: periocular sebaceous carcinoma and extraocular sebaceous carcinoma. The more commonly observed type is periocular, which frequently occurs on the upper eyelid. The extraocular type occurs less frequently. Tumor-wide excision with a margin free of tumor cells is necessary to achieve a positive outcome. Aim and objectives: In this paper, we present a case of this rare cancer that occurred at a site where it rarely appears: the posterior scalp. Materials and methods: An 88-year-old man with a posterior scalp tumor was admitted. The tumor became increasingly large with ulceration and frequent bleeding. Physical examination revealed that the tumor measured up to 4.5 × 4.5 cm, with ulceration at the posterior scalp. No palpable lymph nodes were observed in the head and neck region. Because of discomfort and progressive symptoms, tumor-wide excision deep to the galeal layer with a margin of 1 cm was performed, and the defect was reconstructed through split-thickness skin graft. Results: Histology revealed a typical sebaceous carcinoma with basaloid cells and vacuolated sebaceous cells arranged in lobules. The wound healed favorably, and no local recurrence or distant metastasis occurred during the outpatient follow-up. Conclusion: Extraocular sebaceous carcinoma is one of the rarest skin tumors. Although it is less aggressive than periocular sebaceous carcinoma, early diagnosis and treatment are required to improve outcomes.

關鍵字

sebaceous tumor ； scalp cancer

並列摘要

背景：皮脂腺癌是一種罕見的惡性皮膚癌，起源於皮脂腺。它是一種局部侵襲性腫瘤且具有轉移潛能。一般來說，皮脂腺癌可分為兩大類：眼周皮脂腺癌和眼外皮脂腺癌。最常見的是眼周型，在上眼瞼上最常出現。眼外型發生頻率低於眼周型。治療皮脂腺癌以腫瘤廣泛的切除最有效。目的及目標：在本文中，我們介紹了這種罕見癌症發生在罕見部位的情況。材料及方法：一名88歲男性主訴後部頭皮有一腫瘤。腫瘤在近三年內越來越大且有潰瘍和頻繁出血。理學檢查發現腫瘤長達4.5×4.5公分且合併潰瘍。此外頭頸部沒有摸到腫大的淋巴結。由於症狀越來越嚴重，我們進行了腫瘤廣泛切除，並使用植皮手術來重建傷口。結果：組織學顯示典型的皮脂腺癌伴基底細胞及空泡化的皮脂細胞排列在小葉中。患者手術後傷口癒合良好，且在門診追蹤期間未發生局部復發或遠處轉移。結論：眼外皮脂腺癌是最罕見的皮膚腫瘤之一。雖然它比眼周皮脂腺癌的侵襲性更低，但仍需及早診斷和治療以達到最佳結果。