위눈꺼풀에 발생한 아포크린샘암종 1예
A Case of Apocrine Adenocarcinoma of the Upper Eyelid
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목적: 위눈꺼풀에 발생한 아포크린샘암종 1예를 경험하였기에 이를 보고하고자 한다. 증례요약: 52세 남자 환자가 재발하는 위눈꺼풀의 종괴를 주소로 내원하였다. 4년 전 우측 위눈꺼풀에서 종괴가 발생하여 레이저 시술을 받았으며, 2년 전 재발하여 타 병원에서 조직 절제 치료를 받은 기왕력이 있었다. 본원 초진 당시 위눈꺼풀 경계부위로 소수의결절형태의 종괴가 관찰되었으며, 국소 마취하 절제 생검를 시행한 결과 유두상 한선종으로 진단되었다. 종괴 절제 약 1달 후, 절제경계부위에서 융기된 결절이 다수 관찰되어 재발한 것을 확인하였고, 종괴에 대하여 전 범위절제 및 눈꺼풀 재건술을 시행하였다. 다시 시행한 조직검사 및 이전 조직검사 재판독 결과 아포크린샘암종으로 확인되었다. 조직절제 이후 5개월간 경과관찰하였으며, 재발소견은 관찰되지 않았다. 결론: 아포크린샘암종은 인체의 땀샘에서 기원하는 악성 종양이며, 눈꺼풀에는 드물게 발생한다. 눈꺼풀테 부위의 재발성 종괴가 발생하였을 때 감별진단으로 아포크린샘암종도 고려해야 할 것으로 생각된다.
Abstract
Purpose: To report a case involving an eyelid mass that was diagnosed as apocrine carcinoma. Case summary: A 52-year-old man visited our hospital with a recurrent mass on his right upper eyelid, which had developed4 years prior. Initially, he received laser therapy at a dermatologic clinic to remove the mass. Two years later, themass recurred and was excised at another clinic. At the time the patient visited our institution, the lesion had developed intomultiple erythematous nodules at the margin of the right upper eyelid. The results of excisional biopsy performed underlocal anesthesia revealed hidradenoma papilliferum. One month after excision, recurred multiple elevated nodules werefound at the margin of the excision, and thus total excision of the mass and reconstruction of the upper eyelid wasperformed. Biopsy confirmed that the mass was apocrine adenocarcinoma. Five months have passed since the excisionand no evidence of recurrence has been observed. Conclusions: Apocrine adenocarcinoma is a malignant tumor of the sweat gland and is rarely found on the eyelid. Apocrineadenocarcinoma should be considered in the differential diagnosis of recurrent eyelid mass at the eyelid margin.
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