皮肤混合瘤74例临床及病理分析  

Clinical and Pathological Analysis of 74 Cases with Skin Mixed Tumor

作　　者：张雯[1] 王宁[1] 张婧 郑雪瑞 雷浩 郑延静 郑焱[1] 肖生祥[1] 冯义国[1] ZHANG Wen;WANG Ning;ZHANG Jing;ZHENG Xuerui;LEI Hao;ZHENG Yanjing;ZHENG Yan;XIAO Shengxiang;FENG Yiguo(Department of Dermatology,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)

机构地区：[1]西安交通大学第二附属医院皮肤科,陕西西安710004

出　　处：《中国皮肤性病学杂志》2023年第4期435-440,共6页The Chinese Journal of Dermatovenereology

摘　　要：目的探讨皮肤混合瘤(mixed tumor of the skin,MTS)的临床表现、病理特点及治疗、预后。方法回顾性分析西安交通大学第二附属医院2011年11月—2022年7月经组织病理确诊的74例MTS患者的病史、临床特点、病理特征、治疗效果等资料。结果74例患者中男45例,女29例,平均发病年龄(44.23±13.74)岁,病程中位数为2(1.0,3.75)年。皮损多位于面部(69例,93.24%),其中以鼻部(14例,18.92%)、口鼻间(17例,22.97%)、面颊部(20例,27.03%)多见,也可见于耳部(3例)、头皮(1例)、背部(1例)。皮损表现为大小0.5~3.0 cm孤立、境界清楚、质韧或中等硬度、肤色或红色的结节丘疹,71例(95.95%)皮损表面光滑,3例皮损表面可见顶针状凹陷。17例(22.97%)病例皮损表面可见毛细血管扩张。组织病理:62例混合瘤位于真皮,1例位于皮下脂肪层,11例未见表皮,瘤体位置不明确。54例境界清楚,其中53例有假包膜,20例境界不清。肿瘤由比例不定的上皮及间质成分组成。根据上皮组织成分,63例向顶泌汗腺分化,11例向外泌汗腺分化。17例患者电话随访疗效时失访,其余57例随访2个月~10年9个月无复发。结论MTS临床较少见,临床易误诊,主要依靠病理学诊断,但其预后较好,多数皮损手术切除后无复发。Objective To investigate the clinical manifestations,pathological characteristics,treatment and prognosis of mixed tumor of the skin(MTS).Methods The medical history,lesion characteristics,pathological characteristics and response to treatment of 74 cases with MTS diagnosed by histopathology in the Second Affiliated Hospital of Xi'an Jiaotong University from November 2011 to July 2022 were retrospectively analyzed.Results Among the 74 patients,45 were male and 29 were female.The mean age of onset was(44.23±13.74)years,and the median course of disease was 2(1.0,3.75)years.The most lesions were prone to occur on the face(69 cases,93.24%),most of which were on the nose(14 cases,18.92%),between the mouth and nose(17 cases,22.97%),and on the cheek(20 cases,27.03%);the lesions were also found on the ear(3 cases),scalp(1 case)and back(1 case).The lesions showed solitary,clear boundary,tough texture or medium hardness,skin color or red nodules and papules with size in 0.5-3.0 cm.To be specific,71 cases(95.95%)had smooth surface,and 3 cases had thimble-like depressions on the surface.Capillary dilatation was seen on the surface of skin lesions in 17 cases(22.97%).Histopathology showed that 62 cases of MTS were located in dermis and 1 case was located in subcutaneous tissue.No epidermis was found in 11 cases,and the location of tumor was not clear.The boundary of 54 cases was clear,of which 53 cases had false capsule and the other 20 cases were unclear.Tumors were composed of epithelial and stromal components with variable proportions.According to the composition of epithelial tissue,63 cases differentiated into apocrine sweat glands and 11 cases differentiated into exocrine sweat glands.All 74 patients were treated by surgical resection under local anesthesia.Seventeen patients were lost during telephone follow-up,and the rest 57 patients were followed up for 2 months to 10 years and 9 months without recurrence.Conclusion MTS is a rare disease with a high misdiagnosis rate.The diagnosis mainly depends on pathology,but it

关 键 词：混合瘤 软骨样汗管瘤 临床特点 病理特征 

分 类 号：R751[医药卫生—皮肤病学与性病学] R739.5[医药卫生—临床医学]