하안검에 발생한 원발점액샘암종 1예
A Case of Primary Mucinous Adenocarcinoma of the Lower Eyelid
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목적: 수차례 재발한 우안 하안검의 무통성 종괴를 주소로 내원한 환자에서 눈꺼풀의 땀샘에서 드물게 발생하는 점액샘암종을 경험하였기에 이를 보고하고자 한다. 증례요약: 59세 남자 환자가 피부과에서 5회 레이저 치료를 했음에도 불구하고 우안 하안검 무통성 종괴가 지속되어 본원에 내원하였다. 표층생검 시행 결과 점액샘암종으로 진단되었으며 전층 오각형 쐐기절제술을 시행받고 동결절편 조직검사를 통해 경계부에 종양세포가 보이지 않는 것을 확인하였다. 술 후 시행한 전신 양전자방출단층촬영(positron emission tomography) 및 흉부 전산화단층촬영, 위 ․ 대장 내시경검사 등과 같은 전신검사에서 이상 소견을 발견할 수 없어 원발성으로 발생한 것으로 진단하였다. 술 후 18개월 동안 재발 없이 외래 추적 관찰 중이다. 결론: 원발점액샘암종은 매우 드물게 발생하는 악성종양으로, 형태가 매우 다양하여 최종적으로 조직학적 소견을 통해 진단되어야 한다. 눈꺼풀테 부위의 재발성 종괴가 발생하였을 때 점액샘암종을 고려해야 할 것이며, 국소적인 재발의 위험성이 존재하기에 완전한 수술적 절제가 필요하다.
Abstract
Purpose: To report a rare case of a recurrent painless mass of the right lower eyelid, which was histologically diagnosed as a mucinous adenocarcinoma. Case summary: A 59-year-old male had a painless nodule on the right lower eyelid for 2 years. He had a history of five laser treatments done by a dermatologist prior to the initial presentation. Surgical shave biopsy was performed and a histopathological examination revealed a mucinous adenocarcinoma. We subsequently performed a pentagonal excision of the lower eyelid with assisted frozen biopsy until no tumor cells were seen at the margin. A postoperative whole-body positron emission tomography scan, chest computerized tomography, gastrointestinal endoscopy, and colonoscopy excluded systemic metastases. No recurrence has been observed for 18 months after the surgery. Conclusions: Primary mucinous adenocarcinoma is a rare disorder of the eyelid. Because it has various morphologies, and the final diagnosis can only be made by histopathological examination. If there is a recurrent mass at the eyelid margin, adenocarcinoma should be considered as the differential diagnosis. A complete surgical excision is recommended to prevent local recurrence.
참고문헌 (28)
- Chauhan A, "Primary mucinous carcinoma of eyelid: a rare clinical entity", Indian J Ophthalmol, 57, pp.150~152 (2009)[DOI]
- Lennox B, "Mucin-secreting tumours of the skin with special reference to the so-called mixed-salivary tumour of the skin and its relation to hidradenoma", J Pathol Bacteriol, 64, pp.865~880 (1952)[DOI]
- Mendoza S, "Mucinous (adenocystic) carcinoma of the skin", Arch Dermatol, 103, pp.68~78 (1971)[DOI]
- 서희춘, "상안검에 발생한 원발성 점액샘암종 1예", 대한안과학회지, 48(4), pp.599~603 (2007), 대한안과학회
- 홍성민, "가쪽눈구석 피부에 발생한 원발성 점액샘암종 1예", 대한안과학회지, 50(10), pp.1582~1585 (2009), 대한안과학회
- Kamalpour L, "Primary cutaneous mucinous carcinoma: a systematic review and meta-analysis of outcomes after surgery", JAMA Dermatol, 150, pp.380~384 (2014)[DOI]
- Terada T, "Primary cutaneous mucinous carcinoma initially diagnosed as metastatic adenocarcinoma", Tohoku J Exp Med, 203, pp.345~348 (2004)[DOI]
- Carson HJ, "Mucinous carcinoma of the eyelid. An immunohistochemical study", Am J Dermatopathol, 17, pp.494~498 (1995)[DOI]
- Wright JD, "Mucinous sweat gland adenocarcinoma of eyelid: a clinicopathologic study of 21 cases with histochemical and electron microscopic observations", Cancer, 44, pp.1757~1768 (1979)[DOI]
- Liszauer AD, "Mucinous eccrine sweat gland adenocarcinoma of the eyelid", Can J Ophthalmol, 23, pp.17~21 (1988)
- Gardner TW, "Mucinous adenocarcinoma of the eyelid. A case report", Arch Ophthalmol, 102, pp.912~ (1984)[DOI]
- Segal A, "Mucinous sweat gland adenocarcinoma of the eyelid - current knowledge of a rare tumor", Orbit, 29, pp.334~340 (2010)[DOI]
- Zhang Q, "Mucinous eccrine adenocarcinoma of the eyelid: report of 6 cases", Can J Ophthalmol, 45, pp.76~78 (2010)[DOI]
- Ohnishi T, "Immunohistochemical analysis of cytokeratin and human milk fat globulin expression in mucinous carcinoma of the skin", J Cutan Pathol, 29, pp.38~43 (2002)[DOI]
- Scilletta A, "Primary cutaneous mucinous carcinoma of the cheek", G Chir, 32, pp.323~325 (2011)
- Miyasaka M, "Primary mucinous carcinoma of the skin: a case of metastasis after 10 years of disease-free interval", Eur J Plast Surg, 32, pp.189~193 (2009)[DOI]
- Snow SN, "Mucinous eccrine carcinoma of the eyelid", Cancer, 70, pp.2099~2104 (1992)[DOI]
- Bellezza G, "Primary mucinous carcinoma of the skin", Am J Dermatopathol, 22, pp.166~170 (2000)[DOI]
- Hemalatha AL, "Primary mucinous eccrine adenocarcinoma-A rare malignant cutaneous adnexal neoplasm at an unconventional site", J Clin Diagn Res, 8, pp.FD14~ (2014)
- Krishnakumar S, "Recurrent mucinous carcinoma of the eyelid", Indian J Ophthalmol, 52, pp.156~157 (2004)
- Lee GA, "Clinicopathological report: mucinous carcinoma of the eyelid", Aust N Z J Ophthalmol, 27, pp.71~73 (1999)[DOI]
- Grossman JR, "Primary mucinous (adenocystic) carcinoma of the skin", Arch Dermatol, 110, pp.274~276 (1974)[DOI]
- Boi S, "Mucinous sweat-gland adenocarcinoma of the inner canthus: a case report", Ann Ophthalmol, 20, pp.189~190 (1988)
- 탁민성, "Primary Cutaneous Mucinous Carcinoma of the Eyelid", Archives of Craniofacial Surgery, 17(3), pp.176~179 (2016), 대한두개안면성형외과학회
- 최진희, "Primary Cutaneous Mucinous Carcinoma Treated with Narrow Surgical Margin", Archives of Craniofacial Surgery, 17(3), pp.158~161 (2016), 대한두개안면성형외과학회
- Chavez A, "Primary cutaneous mucinous carcinoma of the eyelid treated with Mohs surgery", JAAD Case Rep, 1, pp.85~87 (2015)[DOI]
- Bindra M, "Primary cutaneous mucinous carcinoma of the eyelid in a young male", Orbit, 24, pp.211~214 (2005)[DOI]
- Maerki J, "Primary mucinous carcinoma of the skin", Eplasty, 13, pp.ic47~ (2013)