背景:涎腺导管癌(SDC)是一种侵袭性癌症,皮肤转移是罕见的。此外,SDC继发于烫伤的皮肤转移更罕见,据我们所知,我们的案例代表了第一个这样的例子。考虑到手指在转移部位的受累,这可能会影响肢体功能和生活质量,我们提出这个病例来探讨烫伤可能导致远处复发的原因和更好的治疗方案。
方法:一名被诊断为腮腺SDC的85岁男子因烧伤而在指尖发现肿大的肿块,6年后,他的初步治疗。
方法:腮腺中SDC的皮肤转移和由于手术导致的左手拇指丢失。
方法:提供放射治疗,瞄准手指上的群众,剂量为15Gy分3次,3个部分中的12Gy,双手在3个部分中为15Gy,左手仅在7个部分中为21Gy。
结果:放疗2个月后肿瘤缩小,患者恢复良好。副作用包括指甲增生和甲沟炎。
结论:本病例中烫伤与恶性肿瘤远处转移的关系有待进一步研究。考虑到手指在处理转移时的保留功能,建议放疗而不是手术。
BACKGROUND: Salivary duct carcinoma (SDC) is an aggressive form of cancer, with cutaneous metastasis being a rare occurrence. Furthermore, cutaneous metastasis of SDC secondary to a scald is even rarer, and to the best of our knowledge, our case represents the first such instance. Considering the involvement of the fingers in the metastatic site, which may affect limb function and quality of life, we present this case to explore the reason why scald could lead to distant recurrence and better treatment options.
METHODS: An 85-year-old man diagnosed with SDC in the parotid gland found enlarged masses at the fingertips as a consequence of a burn, 6 years after his initial treatment.
METHODS: Cutaneous metastasis of SDC in the parotid gland and left thumb loss due to surgery.
METHODS: Radiotherapy was offered, targeting at the masses on the fingers, with dose at 15 Gy in 3 fractions, 12 Gy in 3 fractions, 15 Gy in 3 fractions for both hands and additional 21 Gy in 7 fractions only for left hand.
RESULTS: The tumors shrank after 2 months of radiotherapy and the patient recovered well. Side effects included nail hyperplasia and paronychia.
CONCLUSIONS: Connections between scald and distant metastasis of malignant tumors in this case needed further investigation. Considering reserving function of the fingers while dealing with metastasis, radiotherapy is recommended rather than surgery.