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目的统计我院皮肤科病理室皮肤转移癌患者资料,分析其临床特点,加深对皮肤转移癌的认识。方法报告1例以皮肤表现首诊的胃印戒细胞癌,并综合2011年1月—2016年1月的皮肤转移癌资料,分析患者年龄、性别、皮损形态特征和发生部位等特点,以及原发肿瘤的类型及皮肤转移癌与原发肿瘤发生时间的关系。结果共统计皮肤转移癌14例,占我科皮肤病理室组织病理切片总数0.24%(14/5 955例),其中男5例(36%),女9例(64%),平均年龄(57.46±12.02)岁;9例女患者中,原发于乳腺癌7例(77.8%),胃癌1例,未明确原发灶1例;5例男患者中,原发于肺癌3例(60.0%),食管癌1例,未明确原发灶1例。所有患者中以皮肤表现为首发症状3例,皮肤转移癌首发率21.4%(3/14);11例患者表现为浸润性红斑及红斑基础上的丘疹、结节,2例表现为头皮孤立结节,1例表现为胸腹部多发结节。14例皮损均分布于头颈部及胸腹部。3例患者的免疫组化显示为低分化腺癌,其中1例经及时化疗后皮损基本消失,随访1年已临床痊愈。结论皮肤转移癌发生率低,以皮肤表现首诊的转移癌少见。对于皮肤转移癌早发现、早诊断、早治疗可一定程度改善预后。
Objective To analyze the clinical data of patients with skin metastatic disease in the Department of Dermatology and Pathology of our hospital and analyze their clinical features and deepen their understanding of skin metastases. Methods One case of gastric signet-ring cell carcinoma with skin presentation was reported. The data of skin metastatic carcinoma from January 2011 to January 2016 were collected to analyze the characteristics of patients’ age, gender, lesion morphology and site of occurrence, and The type of primary tumor and the relationship between the metastatic carcinoma of the skin and the timing of the primary tumor. Results A total of 14 cases of skin metastatic carcinoma were accounted for 0.24% (14/5 955) of the total number of histological sections in our department, including 5 males (36%) and 9 females (64%), with an average age of 57.46 ± 12.02) years old. Of the 9 female patients, 7 cases (77.8%) had primary breast cancer, 1 case had gastric cancer and 1 case had no definite primary tumor. Of the 5 male patients, 3 cases were primary lung cancer (60.0% ), Esophageal cancer in 1 case, not clear in 1 case of primary tumor. In all the patients, 3 cases showed the first symptom of the skin and 21.4% (3/14) of the first case of skin metastatic carcinoma. The 11 cases showed papules and nodules on the basis of infiltrative erythema and erythema, and 2 cases showed isolated solitary scalp Festival, 1 case showed multiple nodules in the chest and abdomen. 14 cases of lesions were distributed in the head and neck and chest and abdomen. Three patients showed poorly differentiated adenocarcinoma with immunohistochemistry. One of the three cases had almost disappeared after timely chemotherapy, and was clinically recovered after one year of follow-up. Conclusion The incidence of skin metastatic cancer is low, and the first diagnosis of metastatic cancer is rare. Early detection of skin metastasis, early diagnosis and early treatment can improve the prognosis to some extent.