中华皮肤科杂志 ›› 2016, Vol. 49 ›› Issue (4): 278-280.

• 研究报道 • 上一篇    下一篇

周围组织的Mohs显微描记外科手术治疗乳房外Paget病

万苗坚1,马寒2,龚子鉴1,赵越3,夏悦1,李美荣1,陈贤燕1,赖维4   

  1. 1. 中山大学附属第三医院
    2. 中山大学第三附属医院
    3. 中山大学附属第三医院皮肤科
    4. 广州中山大学附属第三医院皮肤科
  • 收稿日期:2015-06-18 修回日期:2015-12-31 出版日期:2016-04-15 发布日期:2016-03-28
  • 通讯作者: 赖维 E-mail:drlaiwei@163.com
  • 基金资助:

    广东省科技厅社会发展计划项目

Peripheral Mohs micrographic surgery for the treatment of extramammary Paget′s disease

  • Received:2015-06-18 Revised:2015-12-31 Online:2016-04-15 Published:2016-03-28
  • Contact: Wei Lai E-mail:drlaiwei@163.com

摘要:

目的 探讨周围组织的Mohs显微描记外科手术治疗乳房外Paget病(EMPD)的有效性。 方法 对28例EMPD患者术前肿瘤侵犯的深度和范围进行判断,术前1 d外敷20%盐酸氨酮戊酸,伍德灯下观察并标记手术切缘。切取荧光定位后的边缘皮肤组织,按Mohs显微描记外科技术方法仅对周围组织进行冰冻切片检查,同时进行肿瘤切除。术后3 ~ 6个月随访1次,观察局部复发和转移情况。 结果 28例患者中,男25例,女3例。6例患者需要3次冰冻切片,12例患者要2次冰冻切片,平均1.86次。随访5 ~ 72个月,局部复发者3例,1例尿毒症患者随访2年因肝转移死亡。 结论 周围组织的Mohs显微描记外科手术是一省时和有效的治疗EMPD的方法。

Abstract:

Wan Miaojian, Ma Han, Gong Zijian, Zhao Yue, Xia Yue, Li Meirong, Chen Xianyan, Lai Wei Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China Corresponding author: Lai Wei, Email: drlaiwei@163.com 【Abstract】 Objective To evaluate effectiveness of peripheral Mohs micrographic surgery for the treatment of extramammary Paget′s disease (EMPD). Methods A total of 28 patients with EMPD were treated with peripheral Mohs micrographic surgery. The depth and extent of tumor infiltration were evaluated before the surgery. One day before the surgery, 20% aminolevulinic acid hydrochloride was topically applied to determine and label surgical margins under a Wood′s lamp. After fluorescence-based localization, peritumoral skin tissues were resected and underwent frozen-section examination according to the protocol for Mohs micrographic surgery. Meanwhile, the tumor was resected. After surgery, patients were followed up every 3 - 6 months to detect local recurrence and metastasis. Results Of the 28 patients, 25 were male and 3 were female. Six patients each underwent 3 sessions of frozen-section examination, and 12 patients each received 2 sessions, with an average of 1.86 sessions for each patient. During the follow-up for 5 - 72 months, local recurrence occurred in 3 cases, and 1 patient died of tumor metastasis and uremia after 2 years of follow-up. Conclusion Peripheral Mohs micrographic surgery is a time-saving and effective treatment for EMPD.