Primary Pharyngeal Malignant Melanoma

A case of Primary Malignant Melanoma of the Pharynx in a young adult is presented for its rarity.     

原发性食管恶性黑素瘤的诊断经验分享

摘 要：［目的］ 探讨如何诊断原发性食管恶性黑素瘤。［方法］ 分析山西省肿瘤医院2005~2015年间收治的3例原发性食管恶性黑素瘤的诊断过程。［结果］ 通过分析病史、内镜下表现、影像学、病理及免疫组化结果对原发性食管恶性黑素瘤不难作出诊断。［讨论］ 原发性食管恶性黑素瘤恶性程度很高,对放化疗都不敏感,手术切除是主要的治疗办法。如何能尽早对原发性食管恶性黑素瘤作出诊断显得尤为重要。     

CK在恶性黑色素瘤中的表达

 目的 检测CK在恶性黑色素瘤中的表达情况及意义。方法 应用免疫组化PV-9000二步法对18例恶性黑色素瘤进行CK、Vimentin、S-100、HMB45的检测。结果 在18例恶黑中CK的阳性表达率为67％(12／18)；其中原发性恶黑16例，CK和Vimentin的表达率分别为63％(10／16)、100％(16／16)；CPK与S-100，CK与HMB45两项均呈阳性表达者各占50％(8／16)，以上四项抗体均为阳性的表达率为44％(7／16)；两例转移性恶黑四项抗体均为阳性表达，占100％(2／2)。结论 CK在原发性和转移性恶黑中均有不同程度的阳性表达。     

皮肤及眼球外原发性恶性黑色素瘤临床病理分析

研究皮肤及眼球外原发性恶性黑色素瘤的临床与病理特征，以提高临床早期诊断率。方法对１８例皮肤及眼球外原发性恶性黑色素瘤进行临床资料分析，病理组织学、免疫组化及电镜研究。结果本组患者平均年龄５１．６岁，以女性为主。     

Phase II Trial of Topotecan in Malignant Melanoma

Topotecan (S-9-dimethyl-10-hydroxycamptothecin hydrochloride SKF 104864-A) is a semisynthetic analog of the alkaloid camptothecin and, similar to the parent compound, a potent inhibitor of topoisomerase I. The cytotoxicity induced by topotecan appears due to interference with the normal breakage reunion reaction of topoisomerase I leading to DNA damage and cell death. Since preclinical studies of topotecan suggested antitumor activity against refractory solid tumors, a phase II trial of the drug was initiated in melanoma patients with recurrent and/or metastatic disease. Topotecan 1.5 mg/m² was given as a daily 30-min infusion for 5 days and repeated every 21-28 days. Seventeen patients were entered into the treatment program with all evaluablefor toxicity but 1 patient, inevaluable for response. There were no objective responses. Toxicity was predominantly severe myelosuppression, which occurred in 12 of 17 (70%) patients. Topotecan in this dose and schedule is inactive in malignant melanoma.     

口腔粘膜原发性恶性黑色素瘤预后因素探讨

 目的　探讨影响口腔粘膜原发性恶性黑色素瘤预后的因素。方法　回顾分析 35例患者的临床及病理资料。结果　全组总的 5年生存率 2 8.6%。其中临床 ～ 期与 ～ 期分别为45%、6.7% (P<0 .0 1 )。雀斑样型、浅表扩散型与结节型分别为 38.9%、1 4.3% (P<0 .0 1 ) ,病变局限于上皮层者与侵及粘膜下层者分别为 50 %、1 9.1 % (P<0 .0 1 )。手术加化疗组 5年生存率 35.7% ,单纯化疗组均于 5年内死亡。结论　口腔粘膜原发性恶性黑色素瘤的预后与临床分期、病理类型、病变侵袭深度及治疗方式有关。     

原发性贲门无色素恶性黑色素瘤1例报道

恶性黑色素瘤好发于皮肤及邻近皮肤的黏膜等，而发生于消化道如贲门的恶性黑色素瘤少见。无色素黑色素瘤是由于在肿瘤细胞中无黑色素颗粒而命名。近来我院收治1例贲门无色素恶性黑色素瘤患者，现报道如下。     

原发性食管恶性黑色素瘤1例报道并文献复习

0引言原发性食管恶性黑色素瘤(primary malignant melanoma of the esophagus,PMME)是一种非常罕见的疾病,易侵及血管,更易出现疾病复发和转移,预后较差。患者诊断时多处于肿瘤晚期阶段,目前尚无标准治疗方案。本文介绍1例晚期食管胃恶性黑色素瘤经过手术治疗、化疗联合抗血管治疗、免疫联合抗血管治疗,至今生存超过1年的个案,并复习相关文献,供同行参考。     

Primary Malignant Melanoma of the Female Urethra: A Case Report

A case of primary malignant melanoma of the female urethra ispresented. A 65-year-old Japanese woman was referred with dysuriaand urethral bleeding. A hemorrhagic blue-black tumor, 3 cmin diameter, was diagnosed as a malignant melanoma by urinarycytology and biopsy. In spite of radical surgery followed byadjuvant immunochemotherapy with beta interferon, dacarbazine,nimustine and vincristine (IFN ß-DAV), the patientdied of the disease one year after surgery because of lung metastasiswhich developed six months after diagnosis. The regional lymphnodes were not involved. In the present paper, we have brieflydiscussed the diagnostic value of cytological examination forthis condition, as well as biopsy, with regard to the risk ofhematogeneous tumor spread.     

原发性食管恶性黑色素瘤1例报告及文献复习

目的探讨原发性食管恶性黑色素瘤的临床特点及其诊断和治疗。方法对本科收治的1例和计算机检索得到的29例原发性食管恶性黑色素瘤的临床资料结合文献复习,进行综合分析。结果最常见主诉为吞咽不适,进食后胸骨后疼痛,伴体重下降或消瘦。肿瘤多位于食管的胸中下段,肿瘤长径平均5.26cm,其中5.0cm以上者19例,占73.1%。食管钡餐检查病灶表现为轮廓较清晰,边缘光滑规则的充盈缺损。胃镜多见腔内息肉样肿物,表面多呈褐色、黑色、灰白色或其它深色改变。术前临床诊断明确率为19.2%。25例接受外科手术治疗。结论原发性食管恶性黑色素瘤预后极差,应提高对其临床特点的认识,以提高术前确诊率。手术是治疗原发性食管恶性黑色素瘤的首选方法,可有效改善临床症状。     

鼻腔原发性恶性黑色素瘤25例临床病理分析

目的观察鼻腔原发性恶性黑色素瘤的形态特点，以帮助临床诊断和治疗。方法对1975年-2006年间诊治的鼻腔原发性恶性黑色素瘤25例的临床资料进行回顾性分析。结果25例中，肿瘤多位于鼻腔外侧壁和鼻中隔，中鼻道10例，鼻中隔6例，中鼻甲4例，下鼻甲3例，鼻底1例，另1例病变范围广无法判断其来源。肿瘤呈黑色或紫褐色21例，呈结节状或菜花状；淡红色表面光滑如息肉状4例；肿瘤触之易出血。结论鼻腔原发性恶性黑色素瘤临床少见，易误诊，应与鼻腔癌、血管瘤、鼻息肉相鉴别；对鼻腔发现的黑色或紫褐色肿物，触之易出血者可作该病的临床诊断，活检应谨慎，以免促进肿瘤转移。     

食管恶性黑色素瘤12例临床病理分析

目的探讨原发于食管恶性黑色素瘤（primarymalignantmelanomainesophagus,PMME）的临床病理特征和鉴别诊断。方法收集12例食管恶性黑色素瘤,观察其临床病理特点,进行免疫组化染色。结果胃镜检查均见食管腔内有息肉样肿物,镜检示肿瘤实质结构复杂,细胞形态多样,瘤细胞呈上皮样、梭形、多形性等,可见散在的瘤巨细胞,部分瘤细胞有黑色素颗粒沉着。免疫组化结果显示：HMB45（＋）、S-100（＋）和Vim（＋）,CK、CD45和NSE均（-）。结论PMME恶性程度高,预后差,应及早发现,并治疗。HMIM5和S-100是恶性黑色素瘤较为敏感的标记物。与Vim及CK联合检测对恶性黑色素瘤的诊断具有实际应用价值。     

Metastatic Patterns, Clinical Outcome, and Malignant Phenotype in Malignant Cutaneous Melanoma

The objective of this population-based study was to assess metastatic pathways and outcomes vs. selected clinical and histopathologic features of the primary tumor in patients with recurrent cutaneous malignant melanoma. At a median follow-up time of 11 years, 569/2&493 patients with recurrence were identified. We demonstrated a 5-year survival rate of 82% and 30% among those with a primary local or regional recurrence, respectively. Patients with primary distant skin, distant lymph node, or pulmonary metastases had a significantly better survival compared with those with CNS, bone, visceral, liver, or multiple sites of first distant metastases. The metastatic pathways were similar with regard to histogenetic type, primary tumor thickness, Clark's level of invasion, and primary tumor ulceration. Different histogenetic types, as assessed by light microscopy, imply different risks of recurrence. However, once the recurrence is manifest, the metastatic pathways are uniform, as well as prognosis, and survival.