Accompanied by family members, the 91 year old man came to the plastic surgery clinic of Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine recently, and a pungent smell filled the entire consulting room.
When the gauze was untied, all the doctors on the scene uttered an exclamation. There was a "mushroom like" tumor on the top of the patient's head, the skin surface had been ulcerated, and a large number of purulent secretions were accompanied by bloody fluid. The doctor revealed that what the old man got was a rare tumor from skin appendages. Chen Rui, the director of plastic surgery of Renji Hospital, successfully removed the "mushroom on the head" for the old man for five years.
The foreign matter on the top of the old man's head is like a "big mushroom". The pictures in this paper are provided by Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine
On June 18, Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine revealed that five years ago, the old man found a foreign body on his head. As the elderly live alone, they have not paid attention to their condition, leading to the continuous expansion of protrusions. When they came to the hospital, the focus was like a cylindrical "big mushroom" with a size of about 6 * 6 * 5cm. The high protrusions protrude from the scalp and grow, and local stains are broken with necrotic pus moss.
Chen Rui, director of plastic surgery of Renji Hospital, quickly developed a detailed treatment plan for the old man. The first step is to conduct lesion biopsy, and improve preoperative comprehensive examination to assess the safety of the operation. Biopsy showed that the poorly differentiated carcinoma in the subepidermal stroma was diffusely infiltrated, and it was further detected by enzyme-linked immunosorbent assay as a tumor originating from skin appendages.
The second step is implemented immediately. With the cooperation of the Anesthesiology Department, Chen Rui's team carried out the extended resection of malignant tumors in the head combined with the first stage skin grafting to repair the defect and wound left by the focus.
After the operation, the "big mushroom" on the top of the old man's head was removed.
After the operation, the old man recovered well. Two weeks after the operation, when the old man came to the clinic again, his face was already full of smiles and he thanked Dr. Chen Rui for helping him "remove the mushroom on his head".
Chen Rui said that compared with malignant tumors from skin, tumors of skin appendages are less common, and their classification is very complex. According to different origins, primary tumors of skin appendages can be divided into more than 20 kinds of malignant tumors with hair follicle differentiation, sebaceous gland differentiation, sweat gland and eccrine gland differentiation. Among them, sweat glands are relatively common, followed by hair follicles and sebaceous glands.
"Skin adnexal tumors are more common in men than in women. Once distant metastasis occurs, the 5-year overall survival rate is less than 60%." Chen Rui further introduced that at present, surgery is still the main treatment method. However, the current research has revealed gene mutations in this field. Targeted therapy and immunotherapy are expected to be the treatment options for future unresectable malignant tumors of skin appendages
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