Carcinosarcoma Derived From Nevus Sebaceus

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Taipei Medical University Institutional Repository > 臺北醫學大學 • 萬芳醫院 > 內科部 > 期刊論文 > Item 987654321/44694

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題名:	Carcinosarcoma Derived From Nevus Sebaceus
作者:	Che-Yi Chou;Wei-Yu Chen;Kuo-Hsien Wang;Ting-Jui Chen
日期:	2011-07
上傳時間:	2012-01-18 15:00:56 (UTC+8)
摘要:	A 67-year-old man presented with a lesion that had been noticed on his forehead since birth. The lesion was slowly enlarging and had recently become ulcerated with a 3-month history of rapid growth and spontaneous bleeding. The patient denied any history of irradiation or trauma, and there was no family history of malignancy. Physical examination revealed a 4-cm 3.5-cm tumor composed of a yellowish nodule with focal ulceration and pigmentation (Fig 1). There was no regional lymphadenopathy. The clinical diagnosis was nevus sebaceus (NS) with malignant change, and an incisional biopsy was performed. Histologic findings with hematoxylin and eosin stain revealed NS characterized by acanthosis, hyperplastic sebaceous glands without hair follicles, and sebaceous ducts with direct opening to the epidermis (Figs 2A and 2B). The NS was accompanied by irregular lobules comprising an admixture of pleomorphic basaloid cells and small numbers of differentiated sebocytes (Figs 2C and 2D). One focus contained a large biphasic tumor (Fig 3A) consisting of basaloid cells with peripheral palisading (Fig 3B) and pleomorphic epithelioid and spindle cells with hyperchromatic nuclei and numerous mitotic figures (Figs 3C and 3D). Immunohistochemical staining showed that the epithelioid and spindle cells (Figs 4A through 4D, asterisks) were strongly positive for vimentin (Fig 4A) and cytokeratin 5/6 (Fig 4C), moderately positive for cytokeratin AE1/AE3 (Fig 4B) and negative for S-100 (Fig 4D). The basaloid portion (Figs 4A through 4D, arrowheads) displayed positive staining for cytokeratin AE1/AE3 and cytokeratin 5/6 (Figs 4B and 4C) but negative staining for vimentin and S-100 (Figs 4A and 4D). Immunostaining for mismatch repair proteins MLH-1 and MSH-2 demonstrated normal nuclear staining throughout the specimen. Therefore, NS with carcinosarcoma and sebaceous carcinoma (SC) was diagnosed. Thereafter, the lesion was completely excised with safe margin. Neither recurrence nor metastasis had been observed during 1 year of follow-up.
關聯:	Journal of Clinical Oncology. 29(25): 719-721.
顯示於類別:	[內科部] 期刊論文

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