女性尿道原发性恶性黑色素瘤3例报告

目的：探讨女性尿道原发性恶性黑色素瘤的临床特征及治疗手段。方法：对3例女性原发性尿道恶性黑色素瘤进行临床病理分析及随访观察。结果：3例均以尿道外口包块就诊。2例因术前诊断不清，仅局部切除，其中1例术后半年死于肿瘤复发。1例正在随访中；1例行全尿道切除，双侧腹股沟淋巴结清扫及永久性膀胱造瘘。结论：女性尿道原发性恶性黑色素瘤恶性度高，临床易误诊，早期确诊的主要依据是病理学检查，及时规范手术是提高患者生存率的主要手段。     

女性尿道原发性恶性黑色素瘤1例并文献复习

目的 结合文献资料复习,提高女性原发性尿道恶性黑色素瘤的诊疗水平.方法 回顾性分析1例女性原发性尿道恶性黑色素瘤患者临床资料.结果 病例行尿道癌根治术+回肠膀胱术,术后病理证实为尿道恶性黑色素瘤,浸及尿道全层及阴道浆膜面,阴道黏膜及肌层未见癌,膀胱、双侧附件、子宫体、宫颈未见癌,双侧盆腔淋巴结未见转移癌.已随访1年,...     

原发女性生殖道恶性黑色素瘤21例临床分析

目的探讨原发性女性生殖道恶性黑色素瘤的临床特点、治疗及预后。方法回顾分析本院1986年1月至2006年3月收治的原发性女性生殖道恶性黑色素瘤患者21例。其中外阴8例、阴道10例、阴道及宫颈1例、外阴及阴道1例、盆腔1例。结果患者中位年龄50(21~71)岁。临床表现主要为阴道流血、流液及发现外阴或阴道肿物。本资料阴道恶性黑色素瘤发病率高于外阴恶性黑色素瘤。按照国际妇产科联盟(FIGO)分期,期别和预后呈负相关。治疗以手术为主,手术方式由根治性切除逐渐衍变为扩大局部切除。随访:21例患者中随访率为67%(14/21),随访时间6~96个月,死亡7例,随访期间的死亡率为50%。结论女性生殖道恶性黑色素瘤发病率低,预后差。肿瘤厚度和淋巴结转移是其主要的危险因素。应采用手术基础上的综合治疗,治疗方案个体化。     

国外美容医学最新动态(六)

整形美容1女性尿道恶性黑色素瘤原发性尿道恶性黑色素瘤十分罕见,而且发病者死亡率很高。由于是一种少见的疾患,因此有关此病诊断、治疗的资料很少。为此,作者通过PubMed网络收集了有关女性尿道恶性黑色素瘤的资料。通过查阅73个文献,查阅到女性尿道恶性黑色素瘤的患者有112例,患者年龄中数为68岁,患者平均存活期16个月,5年存活率为10%。     

颅内原发性黑色素瘤的诊断及治疗

目的 探讨颅内原发性黑色素瘤的诊治方法。方法 分析１９６８年以来收治的６例颅内原发性黑色素瘤的临床表现、诊治方法和疗效。结果 临床表现无特异性,ＣＴ及ＭＲＩ均难以明确诊断。肿瘤全切除１例。在碚切除３酌,部分切除１例,活检１例。诊断颅内原发性恶性黑色素瘤３例,脑膜黑色素瘤３例。随访５例,３例恶性黑色瘤患者死亡,２例脑膜黑色素瘤３例,随访５例,３例恶性黑色素瘤鹗２死亡,２例脑膜黑色素瘤１例长期卧床,１     

女性尿道恶性黑色素瘤：附三例报告

报告原发性女性尿道恶性尿道恶性黑色素瘤３例，结合文献复习对其发病情况、临床过程、诊断，治疗及预后进行讨论。     

女性原发性尿道癌4例报告并文献复习

目的分析女性原发性尿道癌的流行病学特征、临床表现、诊治措施及预后等,并分享单中心经验。方法回顾性分析自2016年11月至2018年3月就诊于我院的4例原发性尿道癌患者的临床资料,进行了随访,了解其复发、转移及生存情况,并结合文献进行讨论。结果 4例患者均为女性,年龄53～72岁,平均64.5岁;其中2例因尿道口肿物就诊,1例因尿道无痛性出血就诊,1例因阴道分泌物增多就诊。4例患者均病理诊断为原发性尿道癌(3例腺癌,1例大细胞神经内分泌癌)并接受手术治疗,1例患者接受术后辅助化疗。患者随访8～28个月,2例患者带瘤生存,2例患者无瘤生存。结论女性原发性尿道癌临床表现无明显特异性,确诊需依靠病理,且预后较差。治疗以手术切除为主,对于远端尿道肿瘤,推荐在保证切缘阴性的情况下行尿道肿物及肿物内侧尿道切除重建术;而对于近端尿道肿瘤,则推荐行根治性切除术,同时根据情况可适当扩大切除范围以保证达到根治效果。     

原发性肛管直肠恶性黑色素瘤病例1例并文献复习

目的:探讨原发性肛管直肠恶性黑色素瘤(PAMM)的临床及病理特征、诊断和治疗方法。方法:回顾性分析1例原发性肛管直肠恶性黑色素瘤患者的病历资料,结合国内外文献,总结PAMM的临床和病理特点、诊断和治疗方法。结果:该患者术前肠镜提示距肛缘4cm处肿块,肠镜下活检病理提示恶性黑色素瘤,行腹部会阴切除术,术后病理再次证实肛管直肠恶性黑色素瘤。术后患者顺利出院。结论:PAMM是非常罕见的恶性肿瘤,临床表现缺乏特异性,确诊需要病理诊断。预后差,手术切术是治疗原发性肛管直肠黑色素瘤的最佳方案。     

女性原发性尿道癌8例临床分析

目的探讨女性原发性尿道癌的临床特点、治疗及预后。方法回顾性分析2000年1月至2013年12月期间的8例女性原发性尿道癌患者资料并进行随访,了解其转移、复发和生存情况。采用Kaplan-Meier法进行生存分析。结果 8例尿道癌患者以老年女性为主,平均64岁。常见的临床表现为尿道外口肿物、排尿困难及肉眼血尿。尿路上皮癌为其主要病理类型。8例患者均行手术治疗,6例患者行术后辅助化疗。中位随访25.5个月,4例患者死亡,2例患者发生远处转移,2例患者无瘤生存。中位生存期31个月,1年生存率为75.0%,3年生存率为41.7%。结论女性原发性尿道癌是一种罕见且预后较差的恶性肿瘤,治疗方案以手术切除为主,对于晚期肿瘤多建议采取手术治疗、放化疗相结合的综合治疗方案。     

肝脏原发性巨大恶性黑色素瘤1例

目的 提高对肝原发性恶性黑色素瘤的认识并总结该疾病的诊治经验。方法 回顾性分析本院收治的1例肝原发性恶性黑色素瘤患者的临床资料再结合国内外相关文献对该病的临床诊治经验加以总结。结果 肝原发性恶性黑色素瘤临床表现缺乏特异性,术前诊断困难,主要依靠病理诊断,MRI对该病的诊断有很大的价值,治疗上以手术治疗为主,术后可应用放化疗及免疫治疗。结论 肝原发性恶性黑色素瘤术前诊断需要有丰富的经验再结合MRI等影像学检查,治疗是以手术治疗为主结合放化疗、免疫治疗的综合治疗,对延长生命,提高生活质量具有重要意义。     

Primary melanoma of the urethra: a rare neoplasm of the urinary tract

Primary melanomas of the genitourinary tract are rare and constitute less than 1% of all melanomas. Since the clinical presentation of urethral melanoma is similar to commoner urothelial carcinomas, there is frequent delay in diagnosis. A 65-year-old female presented with bleeding per urethra for 1 month. Cysto-urethroscopy showed a gray–white polypoidal tumor in the distal urethra. A biopsy from the tumor showed sheets of cells with moderate cytoplasm, and central vesicular nucleus with prominent nucleolus. Immunohistochemistry for HMB-45 and S-100 protein was positive in the tumor cells. A diagnosis of urethral melanoma was made and radical cysto-urethrectomy with total hysterectomy was done. There was no residual tumor in the urethra; however, sections from bladder neck showed pagetoid spread of melanoma cells in urothelium. No melanocytic lesion was found elsewhere, and a diagnosis of primary melanoma of urethra was rendered. Urethral melanomas are rare tumors, having clinical presentation similar to much commoner urothelial neoplasms. Due to the poor prognosis, the clinician and the pathologists should keep this diagnosis in mind when dealing with urethral tumors with unusual morphology.     

Case of primary amelanotic malignant melanoma of the female urethra

We report a rare case of primary amelanotic malignant melanoma of the female urethra. A 58-year-old female with complaint of nodule on the external urethral meatus was referred to our hospital. Pathological diagnosis of the biopsy specimen from the nodule was malignant melanoma. Computed tomography of the chest and abdomen as well as bone scan showed no evidence of metastasis. Sentinel biopsy from the inguinal lymph nodes revealed no metastasis. Thereafter, the patient underwent radical urethrectomy, whose limits of resection were the bulbocavernosal muscles bilaterally, the arch of the pubic symphysis anteriorly, the anterior vaginal wall posteriorly, and the urethra up to the level of the bladder neck superiorly. The histopathological diagnosis was amelanotic malignant melanoma of the urethra. The patient had received six cycles of DAV-Feron (dacarbazine, nimustine, vincristine, and interferon-beta) in an adjuvant setting, and there is no sign of recurrence 25 months after operation.     

Primary malignant melanoma of the female urethra: Report of a rare neoplasm of the urinary tract

IntroductionMelanoma is a malignant tumor that can affect any area of the anatomical economy. Its occurance in the female urethra is extremely rare. We report a case of primary malignant urethral melanoma developed in an elderly female patient.Presentation of caseA 70 years old female presented with dysuria, poor stream, gross haematuria, intermittent blood spots, and a painful mass. On physical examination, there were no suspicious lesions on the skin. On external genital examination, a lesion at the level of the urethral meatus was observed. The mass was removed by wide local excision under spinal anaesthesia. The pathological diagnosis was malignant melanoma of the urethra.DiscussionThe common presentations include bleeding and/or discharge per urethra, voiding dysfunction and the presence of tumor mass. Survival depends on the stage, location and size of the neoplasm at the time of diagnosis. Despite major surgery, radiotherapy or immunotherapy; malignant melanoma usually has a poor prognosis.ConclusionMelanoma of the female urethra is an extremely uncommon pathology leading to paucity of literature and any definite recommendations regarding management. The histological and immunohistochemical findings can be helpful in making an early and accurate diagnosis of malignant melanoma in the urogenital region.     

Primary genitourinary melanoma presenting as voiding dysfunction

A case of primary malignant melanoma of the urethra in a 67-year-old female is presented. Cystourethroscopy performed during a workup for pelvic organ prolapse revealed a bladder and urethral mass. Initial histologic examination was interpreted as undifferentiated sarcoma; however, after immunohistochemical staining by two separate institutions, malignant melanoma was diagnosed. Being rare, urethral melanoma is often misdiagnosed, and treatment can be delayed. Given its poor prognosis, early diagnosis is essential, and clinicians need to include it in their differential when working up a patient with genitourinary complaint.     

Primary malignant melanoma of the female urethra

We report here on a rare case of primary malignant melanoma of the female urethra. A 69-year-old female presented at our hospital with a several month history of dysuria, poor stream, gross hematuria, intermittent blood spots, and a painful mass at the external urethral meatus. The physical examination revealed a soft, small, chestnut-sized lesion through the urethral orifice. The mass was tan colored, ulcerated, covered with necrotic tissue, and protruded from the external urethral meatus. The mass was removed by wide local excision under spinal anesthesia. The pathological diagnosis was malignant melanoma of the urethra. Computed tomography of the abdomen as well as a whole-body bone scan showed no evidence of metastasis. The patient has been free of disease for 6 months postoperatively. We discuss the clinicopathologic features and treatment of this tumor.     

Non-Hodgkin lymphoma of the female urethra.

The third case of a malignant non-Hodgkin lymphoma of the female urethra is reported. The urethra was the primary localisation of the malignancy. In the two other cases which could be found in a literature review urethral involvement by this disease was secondary to other organs. In all cases the tumor first was described as a caruncle. Non-Hodgkin lymphoma should be considered in the differential diagnosis of urethral tumors.     

Primary malignant melanoma of the female urethra: a case report

A 76-year-old woman visited us with the chief complaint of a urethral mass on September 11, 1984. There was a thumb-sized, brownish and painless mass in the posterior wall of the urethra. Although excretory urogram revealed nothing remarkable, CT scan suggested metastasis of retroperitoneal lymph nodes. Biopsy of the urethral mass revealed malignant melanoma. She was treated with combined chemotherapy of dimethyltriazenoimidazole carboxamide, peplomycin, and cis-diamine-dichloride platinum, but died of respiratory insufficiency on January 6, 1985. Thirteen cases of primary malignant melanoma of the female urethra, including our own, have been reported in the Japanese literature.     

Primary adenocarcinoma of the female urethra: report of two cases

Two cases of primary adenocarcinoma of the female urethra are reported. Case 1 was a 75-year-old female presenting with the complaint of genital bleeding. Physical examination revealed a pea-sized tumor in the urethral meatus. Tumor resection was performed under the preoperative diagnosis of caruncles, but, histopathological examination revealed adenocarcinoma. She was readmitted because of recurrence of tumor 7 months after the first operation. En bloc resection including the bladder, urethra and uterus was done followed by ileal conduit for urinary diversion. Case 2 was an 85-year-old female presenting with the complaint of macroscopic hematuria. Physical examination revealed a thumb's-head-sized tumor in the urethral meatus and also the left enlarged inguinal lymph nodes. Tumor resection and biopsy of the left inguinal lymph nodes were performed. Histopathological examination revealed adenocarcinoma. Postoperative irradiation to the left inguinal lymph nodes was given to a total dose of 4,000 rads. Ninety-two cases of primary adenocarcinoma of the female urethra in the Japanese literature including our cases are reviewed.     

A large primary malignant melanoma of the female urethra

We present a case of large, primary malignant melanoma of the female urethra with poor prognosis in this case report. Malignant melanoma is one of the rare tumors of the female urethra and accounts for 0.2% of all malignant melanoma cases. Large (5.6 cm in diameter), primary malignant melanoma of the female urethra is exceedingly rare.