胆囊转移性恶性黑色素瘤一例

患者男 ,40岁。因上腹部隐痛不适 5年入院。 5年前开始无明显诱因感上腹部隐痛 ,伴膈逆、腹胀 ,阵发性发作后常自行缓解。无厌油腻 ,无向肩背部放射痛 ,无畏寒、无发热 ,皮肤巩膜无黄染 ,无胸闷咳嗽、心慌 ,无呕血、便血等。7年前曾因头部一“黑痣”行手术切除 ,病理报告为“恶性黑色素瘤”。体格检查 :神清 ,消瘦 ,轻度贫血貌 ,皮肤巩膜无黄染 ,浅表淋巴结不肿大 ,心肺未见异常 ,腹软 ,肝脾未见异常 ,右上腹压痛 (+)。Ｂ超示 :胆囊息肉约 2 0ｃｍ× 1 5ｃｍ× 1 2ｃｍ ,于住院第二天在硬膜外麻醉下行胆囊切除术。术中见胆囊周围粘连 ,胆…     

肝脏转移性恶性黑色素瘤手术切除1例报告

患者,男,42y,突发性上腹痛24h入院,呈持续性钝痛,局限在上腹部,6年前曾有左侧眼睑黑色素瘤,已手术切除。体检：一般情况可,生命体征稳定,心肺正常,腹肌紧张,以右上腹为著。彩超显示：肝左外叶前缘和右叶内各见一占位性病变。MRI显示：肝左叶见一类圆形混杂信号软组织块影,肝左叶前腹腔见短T1和长T2亮信号。胰腺及脾脏形态,大小正常,     

胃窦转移性恶性黑色素瘤1例报告

患者,男,63岁.因上腹痛伴便血2周入院.查体: 患者额部巨痣20年,约12 cm×8 cm×2cm大,左上腹部压痛.胃镜检查: 胃窦部见一隆起型肿物,直径约1 cm,肿物表面溃烂,呈灰褐色,质脆,触之出血,取胃窦组织2块活检,其病理检查示: 灰褐色软组织两块,直径约0.2 cm.     

手术治疗足底恶性黑色素瘤1例

1病例资料 患者男性,70岁,因＂左足底部黑痣20年,进行性增大伴溢液1月＂入院。查体：左足底近足跟部内侧见3 cm×4 cm大小皮肤黑色素沉着肿块,突出皮肤,表面不光滑,边界不整齐,周围组织无红肿,肿块破溃有黑色溢液,     

肝脏恶性黑色素瘤1例

患者 ,女 ,32岁。因上腹部胀痛不适 4月余入院 ,伴乏力、纳差、消瘦及恶心、呕吐。外院查腹部B超示 :肝癌。查体 :体温 38.0℃ ,肝脏右肋缘下 15 .5cm ,剑突下 10 .0cm ,质偏硬 ,压痛 ,表面光滑 ,肝区叩痛。血AFP及CEA阴性 ,HbsAg(- ) ,白细胞 12 .0× 10 9/L ,中性粒细胞 0 .85。腹部CT示 :肝硬化并肝癌。初步诊断 :①肝硬化 ;②肝癌。予以手术治疗。术中见腹腔有淡红色液体约 2 0 0ml,肝脏弥漫性增大 ,呈暗黑色 ,表面遍布大小不等不规则结节 ,边缘变钝 ,大网膜布满暗黑色斑点 ;切除部分肝组织及大网膜。病理诊断 :肝脏大网膜转移性黑…     

转移性肝脏恶性间质细胞瘤一例

病人，女，57岁，因B超发现右肝囊肿1年余，于入院前1年行常规B超发现右肝囊肿，大小约4．8cm×5cm。因无明显症状且囊肿较小，故未行治疗。入院前1个月，病人出现腹胀，饭后尤甚，伴吞咽困难。同时出现牙龈出血，但无畏寒、发热及黄疸，无恶心、呕吐、呕血及黑便，无腹痛、腹泻。B超示左肝可见约85mm×91mm类圆形稍增强回声，界清，内部呈蜂窝状。右肝可见约166mm×138mm囊性包块，界清，内部密集细点状回声。[第一段]     

原发灶不明的肝脏多发转移性恶性黑色素瘤1例

<正>患者男,65岁,上腹钝痛伴食欲减退1个月,既往无肝炎病史。查体:全身皮肤、黏膜无明显色素沉着,浅表淋巴结无肿大;腹平软,肝、脾肋下未及。实验室检查:HBsAg(-),AFPCEA、CA19-9等肿瘤标记物均(-)。腹部CT:肝实质内见多发大小不等异常密度影,多数呈高密度(图1A),边界较清楚密度不均匀;增强后动脉期病灶轻度强化,门静脉期部分病灶密度低于肝实质,延迟期部分病灶密度略高于肝实质,部分呈环形强化。PET/CT:肝弥漫性大小不等高密度结节、代谢增     

直肠恶性黑色素瘤1例

患者女，70岁，因大便带脓血1月余，于2003年8月16日入院。患者于1月前无明显诱因地出现大便带脓血，为暗红色血液，伴大便次数增多，每天达5次左右，大便能成形，伴肛门下坠感，无腹痛、腹胀，无发热，无明显消瘦。体格检查：全身浅表淋巴结不肿大，心肺正常，腹部无肿块，直肠指诊：     

手术切除特大肝脏海绵状血管瘤一例

笔者所在医院于2006年3月29日手术切除一例罕见特大肝脏海绵状血管瘤，效果良好，报告如下。[第一段]     

胃近端恶性黑色素瘤一例

患者男 ,6 8岁。主因上腹部灼痛不适 3个月 ,经上消化道造影诊为胃体癌收住院。入院后纤维胃镜检查 :贲门下至胃体小弯粘膜凹凸不平 ,质脆 ,易出血 ,表面附有黑褐色污物。病理活检为胃粘膜增生坏死伴有黑色素物质。临床诊断 :胃体贲门癌。采取全麻下左后外侧开胸术 ,见肿瘤位于胃体贲门处 ,约 8ｃｍ× 7ｃｍ× 5ｃｍ大小 ,沿小弯侧浸润。贲门周围及胃左动脉处多枚花生米大小黑褐色结节 ,膈肌、腹膜、小肠系膜等多处可见散在粟粒样黑色结节 ,伴少量淡黄色腹水。诊断 :胃体贲门恶性黑色素瘤。行肿瘤姑息切除、残胃食管吻合术 ,术后随访 6个月 …     

A case of metastatic malignant melanoma presenting with hematuria

We report a case of metastatic malignant melanoma that presented with macroscopic hematuria and lower urinary tract symptoms. Effective palliation of urinary tract symptoms was achieved with transurethral resection of metastatic lesions in the bladder. However, the patient was lost due to widespread disease despite systemic therapy. Solitary or multiple dark blue-black nodular or vegetating lesions encountered during cystoscopy should raise the suspicion of metastasis of malignant melanoma and be investigated accordingly.     

Resection of a right atrial metastatic melanoma with unknown origin of primary tumor.

Cardiac involvement of malignant melanoma is generally part of a widespread tumor dissemination, which is mostly multifocal. Hence the disease is usually not amenable to surgical intervention. We report successful resection of a large intracavitary melanoma to the right atrium, the primary origin of which was unknown. The right atrium was reconstructed with an autologous pericardial patch. At 12-month follow-up the patient remains asymptomatic.     

Spontaneous splenic rupture in metastatic malignant melanoma

Spontaneous splenic rupture is a rare cause of non-traumatic haemorrhage and is of infectious origin in most instances. We present a patient under treatment for abdominal manifestations of metastatic malignant melanoma who developed signs of haemorrhagic shock and where, upon emergency laparotomy, metastases were found to have caused rupture of the spleen. The patient recovered after splenectomy and was continued on systemic chemoimmunotherapy. One year after the incident he died of cerebral metastases.     

Pulmonary metastasectomy for metastatic malignant melanoma

Melanoma is the most deadly of skin cancers, and metastatic disease most commonly first appears in the lungs. Because most patients with early metastatic pulmonary disease are asymptomatic, routine screening with chest radiographs is the most cost-effective method of discovery. The therapy for pulmonary metastatic melanoma has drastically changed over the years. Even today there is no curative immunotherapy or chemotherapy available. The long-term overall survival for these patients is still very poor, but early detection and surgery offers the only hope for control in a small number of patients.     

Compartment syndrome complicating metastatic malignant melanoma.

Compartment syndrome is well documented in the literature. Neoplasia as a cause is a rare. We report a patient with known metastatic malignant melanoma presenting with a compartment syndrome of the arm caused by a relatively slow growing, non-invasive metastatic deposit. This was excised and the patient made an uneventful recovery.     

Pseudomesothelioma resulting from metastatic malignant melanoma.

Isolated pleural metastatic melanoma is an uncommon clinical condition. Clinical diagnosis can be difficult and therapeutic options are limited. We describe a case where there was isolated pleural metastasis, 10 years following complete excision of a superficial melanotic lesion, which presented like a malignant mesothelioma ('pseudomesothelioma').