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하순에 발생한 소낭포성 부속기 암종(Microcystic Adnexal carcinoma)의 치험례
장현석(Chang Hyun Suk),정무혁(Chung Moo Hyeok),장명진(Jang Myung Jin),김용관(Kim Yong Kwan),윤영호(Yoon Young Ho),박영욱(Park Young Yook) 대한구강악안면외과학회 1995 대한구강악안면외과학회지 Vol.21 No.3
Microcystic adnexal carcinoma(MAC) is a relatively uncommon tumor which was first described by Goldstern et al. In 1982 as most commonly presenting facial plaque or nodule. This slow-growing tumor is highly invasive, locally aggressive and deeply infiltrating neoplasm that has recently been recognized as a distinct clincopathologic entity. Microcystic adnexal carcinoma(MAC) is characterized by follicular and sweat gland differentiation and a stroma of dense collagen. Histologically the tumor shows solid islands and strands of squamous cells and sparse small ductal structures, some of them containing central cores of dense eosinophilic keratin. All of them are embedded in a sclerotic stroma. Microcystic adnexal carcinoma is nondescriptive and may be mistaken microscopically for other benign and malignant entities. Microscopically the tumor shows both pilar and sweat gland differentiation and involves the entire dermis and subcutaneous tissue, and invading perineural spaces. The tumor cells involve neryes perineurally or intraneurally. And they frequently extend into underlying structures such as muscle, fat, and bone. Although local recurrences are common after standard surgical excision, metastases have not been reported. Extensive resection of lesions may be necessary to extirpate widespread tumor, particularly those that are long standing or recurrent. Since significantly increasd morbidity is associated with recurrent disease, surgical and histopathologic techniques that stress examination of all margins are indispensable. A 52-year-old male complaining recurrent ulcer formation of the lower lip during past 15 years came to Dept. of Oral and Maxillofacial Surgery, Kangnam General Hospital for the diagnosis of the lip lesion. The incisional biopsy result was the microcystic adnexal carcinoma of the lower lip. As a treatment method we performed V-shaped local wide resection of the lesion and direct closure. Wde followed up the patient for 17 months after surgery. The patient did not show recurrent sign. We report this rare case of microcystic adnexal carcinoma of the lower lip with the review of literatures.
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