A case of squamous cell carcinoma arising in atheroma of the perineum

会陰部の粉瘤より発生した扁平上皮癌の1例を経験したので報告する.症例は56歳,男性.15年前に会陰部皮膚膿瘍の切開排膿を受け,その後も小腫瘤を時々自覚していた.約半年前より腫瘤の増大を自覚,1ヵ月前より疼痛,悪臭を伴うようになり近医を受診.会陰部の腫瘤生検より扁平上皮癌と診断され当科紹介となった.会陰部に鶏卵大の皮下腫瘤を認めた.腫瘤の中央部は自潰し,辺縁の皮膚は硬く触知した.腫瘤部より約5cm背側に皮下瘻孔で連続した過去の膿瘍切開部があり,皮脂特有の悪臭を伴う白色調の分泌物を認めた.CTでは長径43mmの境界明瞭な腫瘤で,内部に変性と思われる低濃度領域,辺縁部には明瞭な造影効果を認めた.腫瘤背側に皮膚と連続する索状構造が認められた.以上より粉瘤部に生じた扁平上皮癌と診断した.遠隔転移,リンパ節腫大は認めず,全身麻酔下に腫瘍切除術を施行した.病理組織所見は高分化型扁平上皮癌で,断端は陰性,病期分類はT2 N0 M0 StageIIであった.術後3年経過した現在,再発は認めていない.

A 56 -year-old man received the incision and drainage of the perineal skin abscess in 15 years ago. He was constantly aware of the small mass. About half a year ago, he noticed the increase of the mass. He visited a nearby hospital for the pain and bad odor one month ago. The biopsy specimen of the mass showed the existence of squamous cell carcinoma, and he was referred to our hospital. The hen's egg-sized subcutaneous tumor in the perineal area was elastic hard. The central part of the tumor had self-destruction. CT showed well-defined mass in long diameter 43mm with clear contrast effect in the peripheral zone. Lymphnode metastasis or distant metastasis were not recognized. We performed tumor resection under general anesthesia. Histopathological findings showed completely resection of well-differentiated squamous cell carcinoma. Clinical stage was Stage II(T2 N0 M0).Recurrence dose not recognize in postoperative 3 years. We reported a rare case of squamous cell carcinoma that occurred from atheroma of the perineum.

粉瘤

扁平上皮癌

悪性化