악성피부종양 재발했는데 또 수술해야할까요?
2023.8월 처음발견
산책할때 뭐에 물린거같아 연고,미스트 바르고 잠깐 두고보다가 점점커지고 여러군데 퍼져서 동네병원방문.
선생님이 조직검사말씀하셔서 큰병원갔습니다.
시골이라서. .(병원까지 왕복8시간)
악성피부종양진단받고 제거수술2회(2023.10)
다발성?이라 30군데정도 퍼져있는 종양들제거했음
수술후 실밥풀때쯤되서 다시 다른곳에하나 생기더니
지금 수술전이랑 똑같게 여러군데 다시생겼습니다.
크기도 큰거부터 작은것 다양하고, 수술했던곳에 다시생긴것도 있고 새로다른곳에도 생김.
시골이라서 2주정도에 한번씩필요하다는
항암치료에 필요한 혈액검사 등등 못해서
항암치료는 못한상태입니다.
보조제 (타히보) 좋다고해 그것만 복용시키고있는중인데..
아직 별 효과가 없는것같아요. ㅠ
어떻게 치료방법이 없을까요?
큰병원서 조직검사한거 설명은 듣고 사진도받고 했는데
어렵네요~
조직검사진단받은거입니다(영문)
선생님들보시면 도움좀주세요 부탁드립니다.
사진은수술전후와현재모습입니다.
[
I Histopathology Full (1 Site/Lesion)-
DIAGNOSIS
Carcinoma, with lymphovascular invasion, skin mass
GROSS FINDINGS
Specimen: Skin
Appearance: C multiple, Size: 8X7X6cm
Operation: incisional
Recurrence: N, Lymph:N
COMMENTS
The examined skin mass represents a malignant epithelial neoplasm that may be metastatic from an unknown primary site or
primary to the skin; for a primary skin tumor, an apocrine gland origin is most plausible. Malignant apocrine gland neoplasms
tend to exhibit aggressive clinical behavior with metastasis being reported to regional lymph nodes, lung, and lesser bone. It is
plausible that the other clinically mentioned masses removed from this patient could represent metastasis of this neoplasm or the
presently examined mass could be metastasis from a primary site from somewhere else in the body. Further staging is highly
warranted in this case.
MICROSCOPIC FINDINGS
Skin mass (2 sections) The subcutis contains a densely cellular, expansile, demarcated, invasive mass composed of neoplastic
epithelial cells; arranged in packets and aggregates and dense sheets separated by a thin fibrovascular stroma. The epithelial cells
are cuboidal to polygonal,indistinctly bordered, and contain small to moderate amounts of wispy to granular eosinophilic
cytoplasm. Nuclei are round, occasionally indented, centrally located, and contain coarsely stippled chromatin with one variably
prominent nucleolus. Forty mitotic figures are observed within 2.37mm². Anisocytosis and anisokaryosis are mild. Occasionally,
the neoplastic cells form irregular glandular structures with apical blebbing and small ductal profiles. Small multifocal regions of
coagulative necrosis mixed with apoptotic nuclear debris is identified within the center of the mass. The neoplasm multifocally
partially invades the adjacent subcutaneous adipose tissue and small aggregates of the neoplastic cells are identitified within the
lumen of lymphatic vessels. A region of the overlying epidermis is ulcerated by the mass and covered by a thick layer of
serocellular crusting
Randall Walker, DVM, DACVP
안녕하세요. 이은수 수의사입니다.
원칙적으로 재발이든 몸에 새로 난것이든 처음 진료 받았을때와 동일하게 제거하고 조직검살르 받는게 원칙입니다. 주치의와 긴밀한 상담 받아 보시기 바랍니다.