皮膚原発epithelioid hemangioendothelioma(EHE)の1例  [in Japanese] A case of cutaneous epithelioid hemangioendothelioma  [in Japanese]

Access this Article

Author(s)

    • 戸澤 麻美 TOZAWA Asami
    • 愛媛大学医学部附属病院形成外科 Department of Plastic and Reconstructive Surgery, Ehime University School of Medicine
    • 森 秀樹 NAKAOKA Hiroki
    • 愛媛大学医学部附属病院形成外科 Department of Plastic and Reconstructive Surgery, Ehime University School of Medicine
    • 中岡 啓喜 MORI Hideki
    • 愛媛大学医学部附属病院形成外科 Department of Plastic and Reconstructive Surgery, Ehime University School of Medicine

Abstract

39歳,女性。初診の3ヵ月前から左膝外側に圧痛を伴う常色のしこりに気づき,2週間前から色調変化と自発痛を生じた。初診時15mm大の表面赤色調で軽度隆起する硬結を認め,生検によりEHEと診断した。局麻下に20mm離して拡大切除,全層植皮術を施行した。2.5ヵ月後,CTで鼠径および外腸骨リンパ節の腫脹を認め,鼠径部リンパ節生検にて転移と診断した。鼠径および骨盤内リンパ節郭清術施行し,外腸骨リンパ節に転移を認めたが,総腸骨リンパ節には転移を認めなかった。摘出した転移リンパ節から薬剤感受性試験行い,Ifosfamid(IFM)の腫瘍増殖抑制率が84.4%と高感受性であったため,IFM,Doxorubicin hydrochloride(DXR)による化学療法を5クール行い,最終術後3年11ヵ月再発転移を認めていない。皮膚に生じるEHEは稀で,若干の文献的考察を加えて報告する。

A 39-year-old woman presented with a colored lump on her left knee that was causing pressure pain. The lump had first appeared 3 months earlier, and spontaneous pain that developed 2 weeks before admission led her to seek medical attention. On examination, there was a slightly raised, red, indurated area that measured 15 mm in diameter. This was diagnosed as an epithelioid hemangioendothelioma (EHE) after biopsy. The lesion was excised with a 20-mm margin and an all-layer dermoplasty was performed. Lymph node enlargement developed in the groin 2.5 months later, and computed tomography (CT) showed enlarged lymph nodes near the external iliac artery. A lymph node biopsy led to a diagnosis of metastasis. She was given five cycles of chemotherapy with adriamycin and ifosfamide. The patient remains in remission with no metastasis 47 months later. EHE in the skin is reported only rarely.[<i>Skin Cancer (Japan)</i> 2013 ; 28 : 329-335]

Journal

  • Skin Cancer

    Skin Cancer 28(3), 329-335, 2014

    The Japanese Skin Cancer Society

Codes

Page Top