Neuroendocrine tumor skin metastases
Introduction
Introduction to neuroendocrine tumor skin metastasis Neuroendocrine tumors (neuroendocrinetumors), a neuroblastoma, is a tumor of the origin of the adrenal gland and is the most common cancer in neonates. Among them, 32% of neonates are associated with metastatic carcinoma of the skin, and 3% of other age groups are associated with it. Skin metastasis. In elderly patients, carcinoid tumors occasionally metastasize to the skin. basic knowledge The proportion of illness: 0.005% Susceptible people: no special people Mode of infection: non-infectious Complications: neuroendocrine tumor skin metastasis
Cause
Neuroendocrine tumor skin metastasis
The cause is still unknown.
Prevention
Neuroendocrine tumor skin metastasis prevention
There is no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease.
Complication
Neuroendocrine tumor skin metastasis complications Complications neuroendocrine tumor skin metastasis
The systemic metabolism is low, and the nose is not allowed.
Symptom
Neuroendocrine tumor skin metastasis symptoms common symptoms nodular endometriosis subcutaneous nodules implanted nodular skin metastasis
Neuroblastoma skin metastases are scattered, solid blue subcutaneous nodules, no tenderness, can move, white after local scraping and last for 30 to 60 minutes, carcinoid tumors appear as single or multiple dermis or subcutaneous knot Section, there may be pain, skin metastasis from Merkel cell carcinoma is usually solid, pale red non-ulcerative nodules, diameter 0.4 ~ 0.8cm, thyroid cancer skin metastasis is flesh-colored or purple-red skin nodules often involving the head And abdomen.
Examine
Examination of skin metastasis of neuroendocrine tumors
Neuroblastoma Skin metastases are clusters of small basophils with many mitotic figures, forming rosettes, located in a fine fibrillar eosinophilic matrix, which is located in the dermis and subcutaneous fat layers. It consists of a round nucleus and a transparent or eosinophilic cytoplasm. The cells of the same size and shape are arranged in an island shape, nested and cord-like. The Merkel cell skin metastasis has a vesicular nucleus, a small amount of cytoplasm and many nuclear divisions. Circular basophils, like clusters or formation of anastomotic or flaky, tumor cells of the same size and shape, thyroid papillary carcinoma, metastatic carcinoma of the skin composed of ductal papillary structures, occasional sand tumors and dark hobby Acidic gelatinous substance, follicular thyroid cancer Skin metastasis is trabecular and follicular, accompanied by intracavitary gelatinous substance. Thyroid medullary cancer Skin metastatic carcinoma is located in fibrovascular by flaky polygonal or plump fusiform cells. It is composed in a matrix, which often contains lymphocytes and amyloid substances.
Special staining and immunohistochemistry: carcinoid from the bronchus, silver-positive silver-positive particles, positive for silver staining, small intestinal carcinoids containing Fontans-Masson-positive silver-stained particles, immunoperoxidase test, small neuroblasts Circular basophils are neuron-specific enolase (NSE) and neurofilament-positive, and stromal spindle cells S-100 protein positive suggests that their cells differentiate like Schwann cells, and Merkel cell carcinoma has neuroendocrine And epithelial differentiation, they have a unique spheroidal staining near the nucleus and nucleus, similar to cytoplasmic inclusions and small round dots around the nucleus, using low molecular weight keratin antibodies such as AE-1, CAM-5.2 and nerves Filament staining showed that Merkel cell carcinoma epithelial membrane antigen, chromogranin, neurofilament and NSE staining were also positive, but S-100 protein, carcinoembryonic antigen and leukocyte common antigen staining were negative, and lung metastasis was small. Cell carcinoma stained with low molecular weight cytokeratin showed a diffuse perinuclear spot appearance, and staining with anti-neurofilament antibody showed a slight degree of appearance, although Merkel cancer was negative by CEA staining. However, about 50% of metastatic small cell carcinoma CEA staining is positive, papillary and follicular thyroid cancer, thyroglobulin immunostaining positive, myeloid thyroid cancer, calcitonin staining positive.
Diagnosis
Diagnosis and differentiation of neuroendocrine tumor skin metastasis
diagnosis
According to clinical manifestations, the characteristics of skin lesions and histopathological features can be diagnosed. The following points should be noted:
1. Clinically short-term (6 to 12 months) rapid growth of tumor nodules, distributed in primary tumor surgery
The skin near the area or the corresponding lymphatic drainage area, and its histopathological morphology is similar to the primary tumor.
Especially when it has the characteristics of multiple or multifocal tumors, it should be considered as a metastatic cancer of the skin.
2. Tumor plugs are found in the skin or subcutaneous fat vessels or lymphatic vessels. The distribution configuration of the cancer is narrow and trapezoidal at the bottom, generally not connected with the epidermis, there is very little inflammatory cell infiltration around the tumor cells, and no sweat gland ductal keratin membrane Differentiation, etc., are often characteristic of metastatic skin tumors.
3. It is helpful to distinguish by means of immunohistochemical markers. For example, the tumor originated from the sweat gland-derived tumor is positive for GCDFP-15, while the tumors of the prostate and thyroid metastasized to the skin are positive for PSA and TG, respectively. In addition, metastatic skin in the umbilical cord Nodules must be excluded from endometriosis or implanted nodules, and should also be distinguished from yolk sac or urinary tract embryo residues.
Differential diagnosis
Neuroblastoma skin metastases, differentiated from carcinoid tumors.
