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病例女,78岁。因右手背皮肤肿物16年进行性增大并糜烂、疼痛1年入院。此前曾分别在两个医院门诊求治,均诊断为皮肤鳞癌建议手术治疗。检查:右手背有一约4 cm×4 cm×3 cm 大小的圆形肿物,表面糜烂、破溃如菜花状,周围有2～3 cm 的皮肤潮红区。触之质硬韧,不活动,有压痛(图1)。右腋下可触及直径为0.5cm 的两个肿大淋巴结,质中,活动,无压痛。X 线胸片提示:双肺纹理增粗.可见多个钙化结节。拟诊为右手背慢性溃疡继发鳞状细胞癌。入院后1周,在强化局麻下行右手背肿瘤扩大切除,真皮下血管网皮片移植修
Case female, 78 years old. Due to right-sided back skin mass 16 years of progressive increase and erosion, pain, 1 year admission. Had previously sought treatment in two hospital clinics, were diagnosed with squamous cell carcinoma of the skin recommended surgical treatment. Check: The right hand has a circular tumor of about 4 cm × 4 cm × 3 cm size, surface erosion, rupture as cauliflower, surrounded by 2 ~ 3 cm of the skin flush area. Touch the hard and tough, inactive, tenderness (Figure 1). Right axillary palpable diameter of 0.5cm two enlarged lymph nodes, quality, activity, no tenderness. X-ray chest tips: thicker lungs texture. Visible multiple calcified nodules. To be diagnosed as right-sided chronic ulceration secondary squamous cell carcinoma. One week after admission, the patients underwent local enlargement and resection of the right back with enhanced local anesthesia, subdermal vascular net graft