耳鼻颌面部恶性黑色素瘤(附11例分析)  

Malignant Melanoma of the Head and Neck - Report of 11 cases

作　　者：黄方[1] 吴春林[1] 

机构地区：[1]福建医科大学附属二院耳鼻咽喉科,福建泉州362000

出　　处：《临床肿瘤学杂志》2003年第5期365-367,共3页Chinese Clinical Oncology

摘　　要：目的:探讨发生于耳鼻颌面部恶性黑色素瘤(恶黑)的诊疗方法。方法:对1986～2001年收治的11例恶黑患者的临床资料进行临床病理分析。结果:男性6例、女性5例,年龄6个月～83岁;原发部位:牙龈粘膜2例,外耳道1例,耳廓2例,鼻腔筛蝶窦1例,鼻中隔1例,中耳1例,下睑腮腺1例,上唇2例;手术切除9例,术后化疗2例,术后放疗3例,未治疗2例。0.5～10年随访,死亡6例,生存期6个月～3年;健在5例,生存期1.0～15年。结论:恶黑在皮肤粘膜交界处的色素层或粘膜黑色素斑的基础上发生,肿块多呈黑褐色且常伴溃疡,诊断较易,而对于不含黑色素的恶黑容易误漏诊,须待病理确诊。瘤细胞内含大量黑色素颗粒为其病理特点,免疫组化显示VIM-HMB45和S-100蛋白及Vs38阳性反应均有助于不含色素的恶黑的确诊。本病恶性度极高,可采用手术、放化疗或免疫治疗,但预后差。Objective:To find the diagnosis and treatment methods of the malignant melanoma in head and neck. Methods: 11 patients with malignant melanoma of the head and neek were analyzed from 1986 to 2001. Results: Male 6 eases, Female 5 eases, A-mong 11 cases, primary position of 4 eases were in oral cavity and gum muscoal, 3 in external ear, 2 in nasal cavity and sinuses, 1 in middle ear, 2 in lower eyelid and partoid. Nine patients were treated with surgery, radiotherapy and chemotherapy. Follow-up from 0. 5 - 15 years. Result showed that six patients had died of recurrence or distant metastasis of tumor, which survival time was 0. 5 - 3 years. Five patients still were alive, which survival time was 1-15 years. Conclusion:The differential diagnosis of these tumors with nasal cavity and sinus carcinoma, nasal polyp and angionoma was noted. The pathological characteristics of malignant melanoma showed a typical fore-melanin body in different tumor cells. It's a great role in the diagnosis of the malignant melanoma without mela-nine ( amelanotic melanoma). Extensive excision of primary tumor should be an important factor for prognosis of patients with malignant melanoma.

关 键 词：耳鼻颌面部 恶性黑色素瘤(附11例分析) 头颈部 病理特点 免疫组化 

分 类 号：R739.5[医药卫生—肿瘤]