Rare disease: sweat gland cancer

Sweating, a rare disease that according to the world literature, as of 1976, only 48 people in the world have this disease now, have appeared in Vietnam. Particularly in the southern region, there are currently 4-5 cases of the disease with the onset of a " hardening in the skin ".

Currently, in addition to the common cancers of the lungs, liver, throat, esophagus, colon, stomach . the sweat gland cancer (TMH) sounds strange! However, in the last few years, in the provinces and cities in the South, there have been a few unfortunate patients who suffer from this disease. If not detected early, treatment with appropriate regimens will result in a very high risk of death. .

Cancer TMH is so rare that even some cancer doctors are surprised to hear mention of this disease .

From a " hard lump in the skin " .

To help learn about this disease, Dr. Bui Chi Viet, Deputy Head of Department of Hospital - Ho Chi Minh City Cancer Hospital has enthusiastically helped to record medical records of hundreds of patients at Cancer Hospital. Ho Chi Minh City for many years.

From archived records, since 2002, there have been only 4 cases of TMH detected, that is, in 2002, Ms. Ngo Thi Luong (SN 1977, Phung Hiep, Can Tho); in 2003, there were Mrs. Tran Thi Duc (SN 1945, District 4, Ho Chi Minh City); In 2006, there were two cases: Mr. Tran Hong Tho (SN 1969, Mang Thit, Vinh Long) and Mr. To Mao (SN 1937, Phan Thiet, Binh Thuan).

All four of these cases have a ' hard skin ' located at the base of the lower leg, right thigh or left and the shoulder of the arm. In particular, Tran Hong Tho patient initially only appeared a tumor in the left leg but must pass 5 times with 10 times of radiation therapy (also called ionizing radiation), the patient will be temporarily stabilized. through the re-examination in March 2007.

Please apply for the case of a female patient named Nguyen Thi Thuong (SN 1952, Tan Thien, Ham Tan, Binh Thuan) who are now dead, not found in the file of archiving medical records of the City Cancer Hospital. HCM. The author of this article explores information about the above case from the treating doctor and the patient's family.

Despite treatment, the recurrence rate is still high: 59%

The patient is being treated at the Internal Medicine Department - Ho Chi Minh City Oncology Hospital (Photo: H. Cat)

Accordingly, in September 2001, Ms. Thuong was 49 years old and went to Ho Chi Minh City Cancer Center (now Ho Chi Minh City Cancer Hospital) to check with an initial sign of a lump behind her near Old neck occipital pain. Before that, because she was not in pain, Ms. Thuong did not care, but only after a short time when the lump was swollen near the chicken egg, did she feel uncomfortable and aching in the back.

After diagnosis by histopathological method, ie diagnosis of malignant degree by biopsy, doctors identified Ms. Thuong with TMH cancer in the back.

Thuong's family left the limbs when they learned about this news because for a long time, it was simply a normal ' lump ' on the skin, so they did not care and wondered how the 'sweat glands' could be affected. If it is possible, ask the doctor to treat it directly. This is explained as ' strange disease '.

After that, Thuong was assigned to have surgery and radiation therapy. During the 4-month treatment period, Ms. Tho was discharged and completely recovered. The health has recovered, the tumor has been completely removed so she is assured of living with ' peace ' with it.

But unfortunately, she was in a recurrence rate of 59% . It was only after three years, in 2005, that she suddenly felt tired, not eating well and losing sleep regularly, especially especially aches and pains in the backbone. Ms. Thuong suspected she had spine but had no results.

What Ms. Thuong did not think about was that the previous tumor had been removed, but now it has recurred and moved to metastasis into bone. As Dr. Bui Chi Viet said, once the abnormal tissue mass is removed, the margin of the specimen must also be carefully tested to determine if the malignant tissue has actually been removed. If the cancer spreads to another important part of the body (metastasis), surgery at this stage is just a ' fire ', if not, it becomes meaningless.

Indeed, after returning to the Ho Chi Minh City Cancer Hospital, the doctors here have not yet confirmed that Ms. Thuong still has TMH cancer. She has to wait until the CT scan in the area. back with a cost of 1,000,000 VND / time at Cho Ray Hospital, it is confirmed that Thuong has had metastatic cancer in her bones. At this time, the family suggested that the surgery be carried out ' water still slapped ' to prolong the patient's life but it seems that all are too late now.

Newly, at first, there was only a small lump in the back that did not care much, but when it recurred and invaded the bone, Thuong suffered severe pain, completely insomnia and had to resort to strong painkillers. Cyclohexanol 50 mg, or Tramadol, an addictive drug containing Morphine. This is a medicine used only when directed by a doctor to ease pain in the body.

At that time, Western medicine seemed to give up hands . Ms. Thuong sought to find traditional medicine remedies to salvage hope to find a fortune.

But after more than half a year of finding a teacher, running medicine and outpatient treatment at Cho Ray Hospital and Ho Chi Minh City Cancer Hospital, Ms. Nguyen Thi Thuong passed away in May 2006. At that time, her body weight was less than 37 kg!

Ms. Nguyen Thi Thuong was recognized as the first patient who died at least in the last 5 years due to cancer of the back region.

Sweat gland cancer

The sweat gland cancer (TMH) has symptoms that are initially not as important as a small lump on the thigh, legs, shoulders or back.Many people think it's just a benign tumor, but then the tumor suddenly increases in size, making people feel uncomfortable and aching.Although surgery to remove tumors from an early stage in combination with chemotherapy, radiotherapy is considered the most effective treatment regimen, but the risk of death of this type of disease is still high because of the recurrence of it's up to 45-59%!

According to Dr. Bui Chi Viet, the characteristics of TMH cancer is that there is no specific clinical diagnostic picture, usually it is the manifestation of hard, burning, ulcerous skin lesions on the surface of the red skin to slightly dark purple or sometimes appear in the upper limbs, lower limbs of the body, the vagina or around the anal area.The tumor grows slowly and suddenly increases in size invades the surrounding structure of the skin, invades and metastasizes into the bones, lungs, rarely finds metastasis in the brain, kidneys.When treating, it is common to use a wide-cut surgical method with lymph node treatment when metastasis occurs.However, the likelihood of relapse is 45-59%, so it is difficult to predict what will happen to people with this disease.

Meanwhile, Dr. Doan Huu Nam, Head of Planning-General Department - Ho Chi Minh City Oncology Hospital said that every year, Ho Chi Minh City Oncology Hospital receives more than 30,000 types of cancer cases.In 2006 alone, there were 859 cases of skin malignant tumors, of which, TMH cancer is located in the skin cancer of the appendage including cancer of hair follicles, secretions of sebaceous glands and sweat glands.There is no concept of TMH cancer in the classification report.

Quyen