巨大寻常疣继发原位鳞状细胞癌1例

报告1例巨大寻常疣继发原位鳞状细胞癌。患者男,54岁,右膝关节斑块10年,破溃结痂2年。皮肤科检查:右膝关节内侧见一范围约5 cm×6 cm角化性斑块,表面乳头状突起,可见厚层痂壳,边界清楚,无破溃、渗出,有臭味,局部轻压痛。皮损组织病理示:表皮角化过度伴角化不全,棘层肥厚,表皮突向下延长,真皮乳头瘤样增生,乳头状突起之间的凹陷处可见明显的颗粒细胞,表皮上部可见挖空细胞;部分表皮全层细胞排列紊乱,大小形态不一,可见异形细胞和角化不良细胞,基底细胞层完整。真皮浅层可见混合炎性细胞浸润。诊断:巨大寻常疣继发原位鳞状细胞癌。予手术完整切除联合植皮治疗,术后半年电话随访,术区恢复良好,无新发皮损。

A case of squamous cell carcinoma arising from giant verruca vulgaris

A 54-years-old man presented with a plaque on his right knee for 10 years, with ulceration and scabs for 2 years. Dermatological examination revealed a demarcated, intact, keratinized plaque with tenderness, covered by thick scabs, on the right medial knee. Histopathology showed hyperkeratosis, parakeratosis, acanthosis, downward projection of rete ridges, and koilocytes in the epidermis. Other features included dermal papillomatous hyperplasia, granule cells between the papillary projections, disorganized atypical cells and dyskeratosis, with normal basal layer, in the epidermis. The upper dermis was infiltrated by mixed inflammatory cells. The diagnosis was squamous cell carcinoma arising from giant verruca vulgaris.