Genital tract tumor skin metastases
Introduction
Introduction to genital tumor tumor skin metastasis Genitaltract tumors, the most common skin metastatic cancers in women originating from the genital tract are the ovaries (4%), the endometrium (4%) and the cervix (2%). The pelvic region and the umbilicus of the trunk are the main sites of metastatic cancer of these skins. The male primary tumor is the prostate, and its skin metastasis is less than 1%, which is common in the pelvic region. basic knowledge The proportion of illness: 0.0025% Susceptible people: no special people Mode of infection: non-infectious Complications: endometrial cancer
Cause
Reproductive tract tumor skin metastasis
(1) Causes of the disease
The cause is still unknown.
(two) pathogenesis
Primary metastatic cancer of the metastatic tumor is a type of metastatic malignant tumor confirmed by biopsy but not found in the primary site. It is not easy to find because of small lesions, hidden parts or under the mucosa; and the biological behavior of the tumor is worse, and metastasis occurs earlier. It is especially important to look for the primary lesion carefully in clinical practice. Only when the primary lesion is found and the specimen is treated, the clinical cure rate can be improved.
Prevention
Reproductive tract tumor skin metastasis prevention
Usually pay attention to participate in physical exercise, change your own low mood, maintain strong energy, thereby improving the body's immune function and disease resistance; pay attention to diet, drinking water hygiene, prevent cancer from entering the mouth; do not eat moldy, corrupt, burnt food And smoked, grilled, marinated, soaked food, or not drinking for a long time to store water, no smoking, no alcohol, scientific diet, eat more fresh vegetables, fruits and nutritious foods, develop good health habit. At the same time, attention should be paid to protecting the environment, avoiding and reducing pollution to the atmosphere, diet and drinking water, preventing physical, chemical and parasitic, viral and other carcinogenic factors from invading the human body and effectively preventing cancer.
Complication
Reproductive tract tumor skin metastasis complications Complications endometrial cancer
Metastatic ovarian cancer is usually moderate to well differentiated adenocarcinoma. Metastatic endometrial cancer appears as a solid glandular structure. Skin metastatic cancer from the cervix is usually a poorly differentiated squamous cell carcinoma. Prostatic skin metastases are usually poorly differentiated adult and adult adenocarcinomas. Special staining and immunohistochemical examination: ovarian adenocarcinoma carcinoembryonic antigen (CEA) was positive, but the giant cystic disease liquid protein (GCDFP-15) was negative.
Symptom
Reproductive tract tumor skin metastasis symptoms Common symptoms Nodular herpes non-sweat gland ductal keratin... Skin metastatic inflammatory cell infiltration
Skin metastases from the ovary, endometrium, and cervix, usually one or more skin-colored nodules, occurring on normal skin or scars on the incision. Occasionally, ovarian metastatic cancer is erysipelas-like, skin metastatic prostate cancer It is usually a flesh-colored or purple nodule, and in some cases metastatic skin cancer resembles pyoderma or has a herpes zoster-like appearance due to growth along the nerve sheath.
Examine
Examination of skin metastasis of genital tract tumors
Histopathology: Metastatic ovarian tumors are usually moderate to well differentiated adenocarcinoma, often accompanied by papillary appearance and sand tumors, the latter being small lamellar calcified glomeruli, metastatic endometrial cancer with adenocarcinoma Appearance, manifested as a solid glandular structure, skin metastases from the cervix are usually poorly differentiated squamous cell carcinoma, choriocarcinoma by cytotrophoblasts (large cuboid cells with vacuolated nuclei and lightly stained cytoplasm) And the syncytiotrophoblast (a large cell with irregular nuclei and basophilic cytoplasm), the cluster of cytotrophoblasts surrounded by flaky and cord-like syncytiotrophoblasts forming a plexiform appearance resembling villi, prostate skin Metastatic cancer is usually infiltrated into the collagen fiber bundles by poorly differentiated clusters and adult adenocarcinoma cells (rarely formed glands) with significant epidermal properties.
Special staining and immunohistochemistry: ovarian adenocarcinoma carcinoembryonic antigen (CEA) positive, but large cystic disease disease liquid protein (GCDFP-15) negative, help to identify with breast cancer, choriocarcinoma with high level of circulation Chorionic gonadotropin, which can be found in the urine, is positive for metastatic prostate cancer prostate-specific antigen and prostatic acid phosphatase.
Diagnosis
Diagnosis and differentiation of skin metastasis of reproductive tract tumors
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 the vicinity of the primary tumor surgery area or the corresponding lymphatic drainage area, and its histopathological morphology is similar to the primary tumor, especially When it is characterized by multiple or multifocal tumors, it should be considered as 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
Ovarian metastases are differentiated from erysipelas, skin metastatic prostate cancer and pyoderma, herpes zoster.
