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患者,男性,18岁。因头顶部肿块进行性增大1年入院。患者于2岁时头顶灼伤呈瘢痕性斑秃,其后原瘢痕处又遭石击,创口久治不愈。1988年1月于此处发现有一肿块并进行性增大,外院活检病理诊断为“分化性鳞状细胞癌”。体检:左侧头部斑秃,范围15cm×10cm,其中央见一处蕈状肿块,3.5cm×3cm,表面破溃,有少量分泌物,局部有活动性出血。X线示头颅颞顶部,偏左侧颅骨外板变薄,有骨质破坏,局部密度降低,可见软组织肿块影。1988年1月12日行肿块切除,背阔肌皮瓣游离移植术。术中见肿块基底宽大,基底部之颅骨完全破坏,肿块与硬脑膜紧密粘连。大体标本,肿块4cm×3.2cm×3cm,呈灰红色,表面尚光滑,无包膜,质嫩似鱼肉状。光镜下瘤细胞排列呈巢状或弥散分布,瘤
Patient, male, 18 years old. Due to the progressive enlargement of the top of the head for 1 year admission. When the patient was 2 years old, his head was burned with scarred alopecia areata, and then the original scar was stoned again and the wound was permanently cured. A mass was progressively enlarged in January 1988 and a pathological diagnosis of “differentiated squamous cell carcinoma” was performed in the external hospital biopsy. Physical examination: Alopecia areata in the left side of the head, range 15cm x 10cm, with a verrucous mass in the center, 3.5cm x 3cm, surface ulceration, a small amount of secretions, and local active bleeding. The X-ray shows the top of the skull, the thinning of the outer skull on the left side of the skull, the destruction of the bone, the decrease of the local density, and the appearance of a soft tissue mass. On January 12, 1988, the tumor was removed and the latissimus dorsi myocutaneous flap was transplanted. During the operation, the base of the tumor was large, and the base of the skull was completely destroyed. The tumor was closely associated with the dura. Gross specimen, mass 4cm × 3.2cm × 3cm, grayish red, the surface is still smooth, non-enveloped, tender and tender. Under the light microscope, the neoplastic cells arranged in nests or diffusely distributed.