原发性宫颈恶性黑色素瘤4例临床病理分析及文献复习  

Primary Malignant Melanoma of the Cervix:Report of Four Cases and Review of the Literature

作　　者：段瑶[1] 关铮[2] 刘爱军[3] 

机构地区：[1]中国人民解放军第一六一医院妇产科,武汉430010 [2]中国人民解放军总医院妇产科 [3]中国人民解放军总医院病理科

出　　处：《国际妇产科学杂志》2015年第4期477-480,共4页Journal of International Obstetrics and Gynecology

摘　　要：目的:探讨原发性宫颈恶性黑色素瘤的临床病理特征、治疗及预后。方法:对2002—2012年中国人民解放军总医院收治的4例原发性宫颈恶性黑色素瘤患者的临床病理资料进行回顾性分析,4例均进行随访。所有病理标本均进行免疫组化测定。结果:4例患者中1例为国际妇产科联盟(FIGO)分期Ⅰb1期,1例为Ⅱa期,2例为Ⅲa期。免疫组化检测:4例患者抗黑色素瘤特异性抗体(HMB45)、S-100均为阳性,3例Vimetin阳性,2例Melan-A阳性。4例患者均行手术治疗,2例辅以术后化疗,1例辅以术后放疗。3例患者因术后复发及转移分别存活6,25,40个月后死亡,1例患者术后随访34个月,至今仍无瘤存活。结论:原发性宫颈恶性黑色素瘤预后差,确诊需行病理检查及免疫组化检测且排除全身其他部位黑色素瘤,临床采用FIGO分期,治疗规范尚未确立,目前手术是主要的治疗手段。Objective：To study the clinical presentation,pathological features,treatment and prognosis of primary malignant melanoma（MM） of the uterine cervix. Methods：The clinical and pathological date of four patients with primary cervical MM of PLA General Hospital from 2002 to 2012 were analyzed retrospectively. Their follow-up records were all reviewed. Results： One patient of primary cervical MM were diagnosed FIGO stage Ⅰb1,one was FIGO stage Ⅱa, two patients was FIGO Stage Ⅲa. S-100 protein and HMB45 were positive in the four patients. Vimentin was positive in three of the patients.Melan-A was positive in two of the patients. The four patients all underwent surgical treatment. Two of them used chemotherapy and one used radiation as postoperative adjuvant therapy. One patient died 6 months and one died 40 months for metastasis. One patient died 25 months because of recurrence. One patient has survived for 34 months until now without metastasis and recurrence. Conclusions：Primary cervical MM is a extremely rare neoplasm with poor prognosis. The diagnosis is confirmed by histological examination and immunohistochemical study with exclusion of other sites of melanoma. Standardized treatment is not well established to date. The most popular treatment mode appears to be radical hysterectomy.

关 键 词：恶性黑色素瘤 宫颈 免疫组化 

分 类 号：R737.33[医药卫生—肿瘤]