背景:促结缔组织增生性毛上皮瘤(DTE)是一种罕见的良性附件肿瘤,在组织学上可能模仿恶性肿瘤,包括基底细胞癌和微囊性附件癌。
目的:对流行病学进行系统评价,临床特征,治疗,和DTE的结果数据,重点是将Mohs显微外科手术(MMS)与其他治疗方法进行比较。
方法:使用OVID平台,从一开始就搜索了MEDLINE和Embase的研究,以提供有关DTE的原始数据。
结果:共纳入61篇文献中的338例DTE。MMS(n=24,平均随访41.9个月)后未报告复发/持续(0%),13.1%标准切除(n=38,平均随访16.9个月),电外科/烧灼术为2.1%(n=49,随访3-72个月)。确定了咪喹莫特(n=2)和液氮(n=4)的100%复发/持续。在仅接受活检的患者中,复发率/持续性为12.5%(n=32,平均随访16.5个月).总的来说,各种管理策略的随访时间从2个月到6年不等。
结论:关于DTE结局的数据有限。在这次审查中,手术方式,特别是MMS,与其他选项相比,复发率/持久性最低。鉴于大多数病变是在美容敏感的地方发现的,MMS似乎是积极管理DTE的最佳管理策略。
BACKGROUND: Desmoplastic trichoepithelioma (DTE) is an uncommon benign adnexal tumor that histologically may mimic malignant tumors including basal cell carcinoma and microcystic adnexal carcinoma.
OBJECTIVE: To present a systematic
review of the epidemiology, clinical characteristics, treatment, and outcome data on DTEs, with emphasis on comparing Mohs micrographic surgery (MMS) with other treatments.
METHODS: Using the OVID platform, MEDLINE and Embase were searched from inception for studies providing original data on DTEs.
RESULTS: A total of 338 cases of DTE from 61 articles were included. No recurrence/persistence (0%) was reported following MMS ( n = 24, mean follow-up of 41.9 months), 13.1% with standard excision ( n = 38, mean follow-up 16.9 months), and 2.1% for electrosurgery/cautery ( n = 49, follow-up 3-72 months). 100% recurrence/persistence for
imiquimod ( n = 2) and liquid nitrogen ( n = 4) were identified. In patients who underwent biopsy only, there was a 12.5% recurrence/persistence ( n = 32, mean follow-up 16.5 months). Overall, duration of follow-up varied from 2 months to 6 years for the various management strategies.
CONCLUSIONS: Data are limited regarding DTE outcomes. In this
review, surgical modalities, specifically MMS, had the lowest rates of recurrence/persistence compared with other options. Given that most lesions are found on cosmetically sensitive locations, MMS seems to be the optimal management strategy for actively managing DTEs.