恶性黑素瘤术后皮肤及肝胆转移一例

患者男,70岁.自1983年开始,发现右拇趾跖部发生一约指甲大小的圆形黑色斑片,无痒痛感.     

恶性黑素瘤伴淋巴结转移一例诊疗过程分析

恶性黑素瘤为高死亡率的恶性实体瘤,已经成为人们关注的重要公共健康问题之一［1］。规范诊治流程目前被认为是改善黑素瘤预后的关键。通过对1例伴淋巴结转移的恶性黑素瘤进行回顾分析,探讨恶性黑素瘤术前规范处置要点……     

广泛转移恶性黑素瘤一例

患者男,50岁,干部,因肉眼血尿7个月,加重10d收入我院泌尿科,患者入院前7个月开始出现全程肉眼血尿,间断发作,伴腰痛,有时尿中带有黑色渣样物,经当地医院予以止血等对症治疗,稍有好转。入院前10d患者血尿加重,多呈黑色,无血凝块,为进一步诊治而入院,患者自发病以来,消瘦乏力明显。     

恶性黑素瘤骨髓转移一例报告

患者,男,66岁.因畏寒发热10余天伴咳嗽、右胸痛1周拟诊肺部感染于1981年12月收治.     

直肠恶性黑素瘤远处转移一例

直肠恶性黑素瘤较少见,现遇到一例,同时伴远处转移,报告如下.     

恶性黑素瘤全身皮肤转移一例

患者男,70岁,拾荒者。因左足跟黑色斑块6年,全身皮下结节2年于2012年5月24日就诊本院皮肤科……     

结节性恶性黑素瘤伴广泛转移一例

患者男,65岁,一年前在左侧外踝下出现一绿豆大小的黑色结节,并逐渐增大,出现溃疡.     

结节性恶性黑素瘤伴发肺转移一例

临床资料患者,女,49岁。主因右侧腰部红斑结节5个月,伴疼痛3个月就诊于我院。5个月前无明显诱因右侧腰部出现一约黄豆大粉色结节,无任何症状;患者未行处理,2个月后,原发皮损周围出现类似结节,结节渐增大,颜色变为紫红色,伴有明显疼痛,3周前,结节疼痛加重,颜色变为紫黑色,就诊于当地县医院,超声提示：皮脂腺囊肿,建议行手术切除治疗,术中未发现囊肿组织,术后组织送我院病检。     

结节性恶性黑素瘤一例

患者男,37岁,因右踝前黑色丘疹30余年,增大10个月于2002年5月来我所就诊,患者,30年前有踝关节前皮肤出现一黑色丘疹,无自觉症状,皮损无明显变化,一直未予注意,10个月前皮损明显增大,直径达4.0cm左右,伴疼痛,抓后破溃出血,糜烂渗液,自用乙醇,外敷消炎粉无。病后无发热,消瘦等。     

皮肤恶性黑素瘤胃转移1例

皮肤恶性黑素瘤胃转移１例孙桂珍，张宗琴，孙亚惠，朱晓琳１临床资料患者男，２８岁。１９８７年４月始发现左颗部有一黄豆大小黑褐色皮损，渐增大隆起，有瘙痒感。因打蓝球多次碰撞后，患处出血、糜烂、破溃经久不愈来我院就诊。查体：左颗部耳前上方２０ｍｍ×１７ｍｍ...     

Lymph node sonography in the after care of malignant melanoma

Sonographic and palpatory lymph node findings were compared with the results of surgery or regular examination in a retrospective study of 167 melanoma patients. Sonography proved highly advantageous for diagnosis: whereas palpation indicated tumors at 83 of 277 lymph node locations, sonography showed 36 of the 83 to be false-positive. Moreover, sonography allowed the correct diagnosis of 6 non-palpable lymph node metastases. Sonographic diagnosis was initially uncertain in only 15 cases. Differential diagnoses and the limitations of lymph node sonography are described, and suggestions made for the application of this method in the postoperative care of melanoma patients.     

Regional ganglionar metastasis 24 years after surgical resection of a malignant melanoma

A 40-year-old woman, with type I skin, came to the Dermatology Clinic after noticing a tumor in the armpit. The physical examination revealed a hard, stretched-shaped tumoral node with a diameter of 30 mm, located in the left armpit. It moved on the superficial and deeper layers. In addition, the scar of a large graft was found in the homolateral supraclavicular region, where a malignant melanoma had been excised 24 years earlier. At that time, the primary tumoral lesion had the characteristics of an extensive superficial melanoma with an infiltrating core with vertical growth. The pathologic study of the tumor confirmed the diagnosis of a malignant melanoma with a Clark level II and a 1.17 mm Breslow thickness. Surgery had a margin of 3 cm. At present, the patient is in excellent condition and laboratory tests are normal. Immunologic tests performed showed a slight increase in CD4+, CD45A+, DR+ lymphocytes, CD16+, CD56+, NK cells, and a marked increase in tumor necrosis factor-α (TNF-α) and γ-interferon (IFN-γ) levels (Table 1). Imaging studies (chest X-rays, abdominal ultrasound, bone scintigraphy) did not show any abnormal signs. Computerized tomography confirmed the ganglionic mass, without any other abnormalities. Tc-99m methoxy-isobutyl-isonitrile (MIBI) scintigraphy was performed, showing a focally increased concentration of radiomarker in the left armpit, indicating a thick adenopathic conglomerate (Fig. 1). No other areas of abnormal uptake were observed, not even in the original area of the primary tumor. The surgical exploration of the axillar contents confirmed the presence of adenopathies. Pathology studies showed metastatic invasion of intensely melanin-pigmented and pleomorphic cells, with atypical mitosis.     

Congenital malignant melanoma: a case report

Congenital malignant melanoma (MM) is an uncommon condition that is defined as MM recognized at birth. Its incidence is difficult to determine because of the small number of reported cases and because of problems associated with diagnosis. Generally, Spitz naevus and melanoma have many clinical and histopathological similarities, so it is difficult to differentiate between the two. We describe a rare case of congenital MM in which differential diagnosis from Spitz naevus was problematic. In addition, we review the literature and comment on the prognostic differences among the three types of congenital and infantile MM.     

结节性恶性黑素瘤一例

结节性黑素瘤是一种处于垂直生长期的恶性黑素瘤亚型,占所有黑素瘤的10%～15%。皮损可为隆起的丘疹或斑块,偶尔呈息肉样,可发生于身体的任何部位。本患者,女,30岁。左上臂伸侧暗红色结节5年余,加重1年。皮损组织病理:真皮层见大量肿瘤细胞弥漫性浸润,细胞核大、异形,可见大量核分裂像。免疫组化:MelanA、SOX-10、Ki-67、P53、S-100均为阳性,Clark分级,IV级。诊断:结节性恶性黑素瘤。     

Animal type melanoma: a report of a case with balloon-cell change and sentinel lymph node metastasis

Animal type melanoma is a rare histopathologic variant of melanoma characterized by sheets and nodules of heavily pigmented epithelioid melanocytes that involve the entire thickness of the dermis. This human neoplasm mimics melanocytic neoplasms seen in gray horses and laboratory animals; thus, is termed animal type melanoma. It is quite rare and, with only a few reported cases, its biological behavior is not well understood. We report an example of animal type melanoma on the back of a 27-year-old man. The lesion showed areas of melanoma in situ, which ruled out the possibility of metastatic melanoma. Features of regression were also seen at dermo-epidermal junction and papillary dermis. In some areas, neoplastic melanocytes exhibited a balloon-cell appearance; in others the neoplasm was composed of sheets and fascicles of heavily pigmented epithelioid melanocytes that permeated the entire dermis and extended into the dermal-subcutaneous interface, mimicking a cellular blue nevus. Epithelioid melanocytes in deeper areas showed abundant, heavily pigmented cytoplasm and pleomorphic nuclei with prominent eosinophilic nucleoli and some mitotic figures. The neoplastic cells did not show evidence of maturation in deeper areas of the lesion. In some sections, a nodule of heavily pigmented epithelioid melanocytes was seen far from the main bulk of the lesion, at the dermal-subcutaneous interface, raising the possibility of a satellite lesion. A lymphoscintigraphy showed a sentinel lymph node in the right axilla and a subsequent axillary lymphadenectomy demonstrated that the architecture of the sentinel lymph node was effaced by metastatic melanoma. The patient received adjuvant chemotherapy with inteferon alfa-2b and four months after this treatment the patient is alive and well, without evidence of recurrences or additional metastases.     

Primary malignant melanoma of the oral cavity: a case report

A 43-year-old white man was referred to the Special Care Dentistry Center of the School of Dentistry, University of Sao Paulo, Brazil, for the diagnosis of an extensive nodular lesion of the maxillary gingiva. The patient complained that his left maxilla had swollen over the last 4 months, with some exudation from the gingival crevice, sporadic bleeding, and slight tooth mobility, but no pain. An extra-oral examination confirmed expressive swelling of the left side of the face (Fig. 1A). Palpation disclosed bilateral enlargement of the submandibular lymph nodes. An intra-oral examination showed an extensive, reddish, nodular mass (around 11 cm in diameter) that extended from the last left maxillary molar to the right maxillary incisor, covered by a mucosa that was ulcerated in some areas (Fig. 1B,C). Palpation revealed a painless, soft, bleeding tissue that seemed to arise in the periodontal ligaments, extending to the palate and vestibular area. A small pigmented spot was found in the palatal mass. Histopathologically, the biopsy revealed a proliferation of neoplastic cells that exhibited a wide variety of shapes, including spindle, plasmacytoid, and epithelioid forms. The atypical cells showed enlarged and pleomorphic nuclei. Mitotic activity and pigmented areas were observed (Fig. 2A,B). Immunohistochemistry was used to establish the final diagnosis. The tumor cells strongly expressed S100 protein, gp100 (HMB-45), melan A, and tyrosine antibodies (Fig. 2C,D). With the diagnosis of malignant melanoma, the patient was referred to an oncologist for treatment. As computed tomography revealed that the lesion was deeply inserted into the skull surface (Fig. 1D), surgical intervention was not possible. The patient underwent radiotherapy, but died 14 months later.     

无黑素性黑素瘤伴全身转移1例

报道无黑素性黑素瘤全身转移1例。患者男 ,52岁 ,农民。左下肢有一米粒大小皮色肿物10年 ,增长缓慢。5个月前在基层医院行手术切除后很快发生局部淋巴结转移和全身转移。组织病理见真皮内瘤细胞呈团块状或巢状 ,小血管内可见肿瘤细胞浸润 ,HE染色未见黑色素。免疫病理S100( ) ,HMB45( )。