눈꺼풀 병변으로 진단된 내분비 점액 생성 땀샘 암종 1예
A Case of Endocrine Mucin-Producing Sweat Gland Carcinoma of the Eyelid
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목적: 눈꺼풀의 종괴를 주소로 내원한 환자에서 조직검사를 시행하여 내분비 점액 생성 땀샘 암종을 진단한 사례를 경험하였기에이를 보고하고자 한다. 증례 요약: 64세 남자 환자가 1년 전부터 발생한 오른쪽 아래눈꺼풀의 3×3 mm 크기의 무통성 분홍색 단일 종괴를 주소로 내원하였다. 오른쪽 아래눈꺼풀에서 병변의 절제 및 생검을 시행하였으며, 조직검사에서 국소적인 점액 생성 및 간헐적인 샘 구조와 함께 호산성의 염색질 및 다형성 핵을 갖는 바닥세포모양의 결절(basaloid nodule)이 확인되었다. 면역조직 화학검사 소견상 cytokeratin 7 (CK-7), tumor protein 63 (P63), androgen receptor (AR) 표지자에 양성 소견을 보여 내분비 점액 생성 땀샘 암종에 합당한 결과를받았다. 조직검사 시 생검으로 병변 부위를 모두 제거한 이후 재발 없이 6개월째 경과 관찰 중이다. 결론: 눈꺼풀의 내분비 점액 생성 땀샘 암종은 매우 드문 저등급의 땀샘 종양으로, 병변 부위의 완전한 외과적 절제가 이루어지는경우 재발 없이 양호한 예후를 가지는 질환이다. 눈꺼풀의 종괴를 주소로 내원한 환자에서 이를 진단한 사례를 경험하여 이에 대해보고하고자 한다.
Abstract
Purpose: We report an endocrine mucin-producing sweat gland carcinoma diagnosed by biopsy in a patient who presented with an eyelid mass. Case summary: A 64-year-old male presented with a 3 × 3 mm solitary, painless pinkish mass on the right lower eyelid that had developed over the past year. The mass was excised and a biopsy was performed. The pathological findings included basaloid nodules composed of cells with eosinophilic cytoplasm, focal mucin production, and occasional glandular structures. Immunohistochemical examination was positive for cytokeratin 7 (CK-7), tumor protein 63 (P63), and the androgen receptor (AR). The patient was thus diagnosed with an endocrine mucin-producing sweat gland carcinoma. The lesion healed, and there has been no sign of recurrence over 6 months of follow-up. Conclusions: An endocrine mucin-producing sweat gland carcinoma is a very rare low-grade glandular malignancy that has not been reported in Korea previously. The prognosis is good (i.e., there is no recurrence) when the lesion is completely surgically excised. We thought it would be useful to report this very rare case.
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