手皮肤癌骨侵袭误诊为手恶性骨肿瘤2例
Chinese Journal of Medical Imaging Technology(2020)
Abstract
病例1,患者男,53岁,无明显诱因左小指溃烂伴菜花样肿物形成2月余.查体:左小指背侧及掌侧溃烂,可见脓性分泌物,创面边缘见不规则肿物.左手X线片示左第5掌骨及小指骨密度普遍降低,可见小囊状及片状骨质破坏,边缘不清,以近节指骨基底部及第5掌骨为著,周围软组织明显肿胀,表面见不规则破溃区(图1A),考虑左小指恶性骨肿瘤可能.穿刺活检病理结果为恶性肿瘤.行左手肿瘤切除及清创术,术中见左小指、环指第4、5掌骨间肿物呈菜花状膨胀性生长,自腕关节上2 cm以远切除左腕及左手.术后病理:光镜下见左小指皮肤表层过度角化,其下异型细胞核大而深染,呈巢团状、团片状排列,浸润性生长,多区可见角化珠(图1B).病理诊断:(左小指)皮肤高分化鳞状细胞癌.
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