Mohs显微描记手术联合5-氨基酮戊酸光动力疗法治疗枕部大面积鳞状细胞癌1例  

Mohs Surgery Combined with Photodynamic Therapy Treat Squamous Cell Carcinoma on Occipital

作　　者：杨镓宁[1] 戴耕武[1] 吴冬梅[1] 应川蓬[1] 罗娟[1] 

机构地区：[1]四川省人民医院皮肤病性病研究所皮肤外科,四川成都610031

出　　处：《中国皮肤性病学杂志》2015年第5期534-535,538,共3页The Chinese Journal of Dermatovenereology

摘　　要：患者男,62岁。枕部反复溃烂结痂4年。2年前诊断为鳞状细胞癌,行肿瘤扩大切除,右大腿中厚皮片游离移植术。术后7个月,原皮损处上缘再次出现糜烂结痂,溃烂面积逐渐扩大,疼痛明显。系统检查无明显异常,皮肤科情况:枕部一约5.5cm×2.5cm大小的溃疡,至深筋膜层深面,表面凹凸不平,部分区域可见脓性分泌物。实验室检查:WBC:10.3×109/L,NEU:7.10×109/L。头部MRI检查:颅骨及颅内未见确切异常,左侧枕部局部头皮软组织形态失常伴缺损。诊断:枕部鳞癌术后复发。前期治疗予以5-氨基酮戊酸光动力疗法(ALA-PDT),后期行Mohs显微描记手术,创面游离皮片移植。术后恢复良好,随访8个月未见肿瘤复发迹象。A 62-year-old male presented with 4 years history of repeated ulcerated scab on occipital. Two years ago, the patient had an extensive tumor resection and free skin graft transplantation due to squamous eel1 carci- noma. Seven months later, the original edge changed into erosive scabies and the ulcerated area expanded gradually with obvious pain. No obvious abnormal was found in systemic examination. Dermatologist exami- nation ： An occipital ulcer on the size of 5.5 cm x 2.5 cm was available. It reached the deep layer of the deep fascia with uneven surface and part of purulent secretion. Lab examination：WBC： 10.3 × 109/L, NEU ：7.10 × 109/L. MRI：No exact intracranial abnormalities or problems with the skull. The soft tissue of left occipital scalp showed morphological disorder and defects. Diagnosis ： Postoperative recurrence of oc- cipital squamous carcinoma. Proceeded 5-amino ketones pentanoie acid photodynamic therapy （ALA-PDT） for early treatment, then underwent Mohs surgery to remove the tumor tissues and free skin graft to recover the wound latter. The patient recovered well and there was no evidence of tumor recurrence in next 8-month follow-up.

关 键 词：鳞状细胞癌 光动力疗法 Mohs显微描记手术 枕部 

分 类 号：R739.5[医药卫生—肿瘤]