Recurrent mucinous carcinoma of the skin invading to the frontal skull base

Le résumé fourni par la source

Sir, Mucinous carcinoma of the skin (MCS) was first reported in 1952.1 This tumour has relatively benign morphology clinically and histopathologically. Despite a high rate of local recurrence, cases which result in death are extremely rare. There are only three reported cases with bone invasion.2–4 A 43‐year‐old man had a subcutaneous tumour measuring 80 × 160 mm on the right cheek when he came to our hospital in March 1992. We performed tumour resection and reconstruction using a free forearm flap. The biopsy specimen showed MCS. After the operation, local recurrences occurred nine times in the next five years. All recurrent tumours grew gradually and were palpable as subcutaneous lesions with a clear border, and seemed to be covered with a capsule. In April 1998, a small subcutaneous tumour appeared on the right eyelid. It had grown rapidly over three months (Fig. 1a). The eyeball was pushed up by the tumour and eye movement was restricted. Another tumour appeared on the forehead. CT scan revealed that the tumour filled the maxillary, ethmoidal and frontal sinuses, and invaded to the orbit with destruction of the medial and inferior wall (Fig. 1b). There was no evidence of systemic metastasis. In August 1998, the tumour was resected, including over‐riding cheek skin, the eyeball, and the maxillary bone. The superior wall of the frontal sinus was partially destroyed. The defect was covered with a latissumus dorsi musculocutaneous flap. Twelve months after the operation, there is no evidence of local or systemic recurrence.

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