鼻腔鼻窦恶性黑色素瘤17例临床分析

目的探讨鼻腔鼻窦恶性黑色素瘤的诊断和治疗，提高本病的诊疗水平。方法回顾性分析1980年3月-2011年6月收治的17例鼻腔鼻窦恶性黑色素瘤的临床资料，分析其临床病理特点、诊断、治疗及预后。结果患者的主要症状为单侧鼻塞，涕中带血，头痛；病灶位于鼻腔外侧壁和鼻中隔。17例患者中1例放弃治疗，2例行单纯放疗，14例行手术治疗，3、5年生存率分别为36．4％和22．2％。患者死亡原因为局部复发和远处转移。结论鼻腔鼻窦恶性黑色素瘤恶性程度高，易复发和转移，预后差，临床上尽早确诊。广泛彻底手术切除肿瘤，并辅以放疗、化疗、免疫治疗等综合治疗，是提高本病生存率的关键。

Sinonasal malignant melanoma: A clinical analysis of 17 cases

Objective To discuss the diagnosis and treatment of sinonasal malignant melanoma so as to improve the diagnosis and treatment level of the disease. Methods Clinical data of 17 cases with sinonasal malignant melanoma treated in our department from March 1980 to June 2011 was retrospectively analyzed. Including the elinieopathological features, diagnosis, optimal treatment, and prognosis. Results The main symptoms of sinonasal malignant melanoma were unilateral nasal obstruction, bloody nasal discharge and headache. The tumor originated mainly from the lateral wall of the nasal cavity and nasal septum. Died due to local recurrence and systemic metastasis. In the 14 cases with surgical treatment, the 3- and 5-year survival rates were 36.4% and 22. 2% respectively. Conclusions Sinonasal malignant melanoma is highly malignant with poor prognosis due to local recurrence and systemic metastasis. Early diagnosis and complete surgical resection combined with postoperative radiotherapy, chemotherapy and/or immunotherapy are essential to improve the survival rate.