原发性肺恶性黑色素瘤的外科诊治

目的探讨原发性肺恶性黑色素瘤的临床病理特征、诊断和鉴别诊断以及外科治疗。方法分析我院1980至2008年间5例原发性肺恶性黑色素瘤患者的相关临床治疗,并结合文献复习。结果5例患者中男2例,女3例;年龄41-72岁,平均51.6岁;左上叶2例,右上、中和下叶各1例;症状包括咳嗽、咳痰、胸痛和胸闷不适。术后病理诊断为原发性肺恶性黑色素瘤。无手术和术后住院期死亡。结论原发性肺恶性黑色素瘤临床罕见,诊断主要依据影像学检查和病理检查,治疗首选外科手术完整切除。     

原发性食管恶性黑色素瘤伴十二指肠转移1例

恶性黑色素瘤是一种恶性肿瘤,占胃肠道恶性肿瘤的1-3%[1],分为原发性和转移性。现我们报道1例原发性食管恶性黑色素瘤伴十二指肠转移的病例并复习相关文献知识。     

原发性食管恶性黑色素瘤一例

患者男,69岁,因进行性吞咽困难2个月,近期只能进食流质就诊.外院胃镜疑诊食管血管瘤,未行活组织检查.为明确诊断而入院.既往体健,一般状态尚可,体格检查无明显异常.     

老年原发性食管恶性黑色素瘤临床特征的研究

原发性食管恶性黑色素瘤是一种罕见的高度恶性肿瘤,国内外文献报道较少,对该病发生、发展规律的认识不够深入和明确,尤其对于老年患者更缺少此方面的研究.     

原发性食管恶性黑色素瘤一例

患者男,52岁,吞咽不适2个月,在外院内镜检查时发现食管中段肿物。入我院后,查体全身皮肤未见黑色素瘤。Fujinon EG 485 ZW 变焦放大胃镜检查发现:食管中段距门齿26cm 处可见2.5cm×2.0cm 的肿物,表面呈现黑褐色调,有结节感,高低不平,肿物表面黏膜光滑,似有膜样覆盖物,基底部有相连的蒂样隆起(图1)。碘染色后可见肿物呈深染,未见不染色区(图2)。采用20MHz 频率的 Fujinon     

直肠原发性恶性黑色素瘤一例

患者男 ,60岁 ,因脓血便 2个月入院。 2个月前无明显诱因出现脓血便伴里急后重感 ,大便每天 3次 ,成形 ,量不多 ,表面覆有脓液及暗红色血块。无腹痛、恶心及呕吐 ,无发热。曾在当地医院就诊 ,按感染性腹泻治疗效果欠佳。近 1 0ｄ来仍排脓血便 ,且出现右上腹痛 ,遂到当地医院就诊 ,腹部Ｂ超示肝实质性多发性占位性病变 ,腹部ＣＴ示直肠占位性病变。结肠镜检查在直肠后壁见一 2ｃｍ× 3ｃｍ的包块 ,怀疑血管瘤或直肠静脉曲张 ,未行活检病理检查。患者自发病以来进食少 ,睡眠差 ,消瘦明显。 1 0年前有阑尾切除术史。有吸烟史 30年 ,每天 2 0支 …     

头皮恶性黑色素瘤1例诊治体会

20 0 1年 1月我院收治头皮恶性黑色素瘤患者 1例 ,经手术及化学免疫治疗 ,疗效满意。现报告如下。临床资料 :患者男 ,4 1岁 ,主诉右颈部肿物 3年 ,加快生长伴疼痛半年。曾在外院诊断为颈淋巴结结核 ,抗炎、抗痨治疗无效。入院查体发现右颞顶部头皮有一 1cm× 1cm× 1cm大小肿物 ,表面破溃 ,少量暗黑色粘稠分泌物附着 ,触痛 ,边界不清。追问病史 ,患者右颞顶部原有一高起皮肤的色素痣 ,4年前不慎被高温烫伤后破溃出血 ,经抗炎治疗创面愈合。此后因出现痒感而多次搔抓 ,反复破溃出血迁延不愈。无结核病史及结核密切接触史。查体见右颌后区隆起…     

70例食管原发性恶性黑色素瘤meta分析

目的 探讨食管原发性恶性黑色素瘤(PMME)的临床特点、病理、诊疗方案、肿瘤分期及预后.方法 选取2019年9月厦门医学院附属第二医院收治1例PMME患者,以及在Pubmed、中国知网等相关检索系统,以"primary malignant melanoma of the esophagus,PMME"和"原发性食管恶性...     

食管原发性恶性黑色素瘤一例

患者男，５８岁。吞咽困难伴胸骨后疼痛逐渐加重１个月余。该患幼年时曾误服火碱引起食管灼伤，经治疗后多年来进食略有不畅，此外无任何不适。近期自觉吞咽困难加重，进食稀饭有明显梗阻感，食欲差伴呕吐，消瘦，且有胸骨后疼痛，行纤维胃镜检查。胃镜见食管中下段有一不规则黑褐色肿物，表面不光滑、污秽、质脆、触之易出血，该处食管狭窄向下无法通过，于食管２５　ｃｍ处取活检病理。病理检查：黑褐色碎块组织０．５　ｃｍ×０．３　ｃｍ×０．３　ｃｍ，镜下瘤细胞多呈上皮样，圆形或多角形，少部分呈梭形；细胞核大，圆形，核仁清楚，…     

Primary malignant melanoma of the esophagus

Primary malignant melanoma of the esophagus is a rare neoplasm that accounts for approximately 0.1–0.2% of all esophageal tumors. Many cases are advanced at the time of diagnosis, and survival time is very short. The literature lists only four long‐term (> 5 years) survivors after optimal surgical excision. We present the case of a geriatric woman with a malignant melanoma of the esophagus that showed no pigment on gross inspection.     

Primary malignant melanoma of the esophagus: a study of clinical features,pathology, management and prognosis

Primary malignant melanoma of the esophagus (PMME) is a rare disease that is characterized by aggressive invasion, early metastasis, and poor prognosis. Treatment protocols are not well‐established. To understand this condition more precisely, we performed a retrospective review of eight cases of PMME diagnosed at the Thoracic Department of the Cancer Center at Sun Yat‐Sen University between 1985 and 2009. Eight PMME patients (five men and three women) with a mean age of 58 years (range: 48 to 72 years) were included. Dysphagia was the most common presenting symptom. All patients underwent an Ivor‐Lewis esophagogastrectomy and lymph node dissection with postoperative adjuvant chemotherapy. One patient with stage III/pT4N0M0 underwent postoperative chemotherapy plus radiotherapy. Four patients died of distant metastases. The median survival time was 28 months (range: 11 months to 6 years). Our data confirm that PMME is a highly aggressive disease with a poor prognosis. If the diagnosis is suspected or confirmed as PMME, and the patients have no distal metastases or extensive lymph node enlargement, we suggest that surgery should be the first choice of treatment. With regard to adjuvant therapy, we recommend the addition of chemotherapy. The role of radiotherapy remains questionable and requires further investigation.     

Long‐term outcome of esophagectomy for primary malignant melanoma of the esophagus: a single‐institute retrospective analysis

Primary malignant melanoma of the esophagus (PMME) is a highly malignant tumor with a poor prognosis. Because PMME is an extremely rare disease, therapeutic strategies against the tumor have yet to be established, and the efficacy of esophagectomy remains unclear. The objective of this study was to evaluate the post‐esophagectomy survival of PMME patients. Ten patients who underwent esophagectomy for PMME between March 2005 and April 2013 at the Department of Gastroenterological Surgery, Cancer Institute Hospital, Tokyo, Japan, were identified from the institutional database. We retrospectively retrieved clinical information and data on the long‐term outcomes from the patients' records. Survival rates after esophagectomy were calculated by the Kaplan–Meier method, and the hazard ratios of mortality were determined using the Cox's model. A follow‐up study of the 10 patients revealed 7 cancer recurrences and 5 deaths. Median survival time was 34.5 months, and 5 of 10 patients survived longer than 2 years. The 1‐year disease‐free survival rate was 40%, and the 1‐ and 3‐year overall survival rates were 70% and 60%, respectively. Importantly, all three of the non‐relapsing patients were histologically confirmed as free of lymph node involvement. The four patients with lymph node metastasis relapsed within 1 year. The disease‐free survival was significantly shorter in patients with lymph node involvement than in those without lymph node involvement (univariate hazard ratio = 13.3, 95% confidence interval 1.85–266.4; P = 0.009). In conclusion, esophagectomy might benefit PMME patients with no lymph node metastasis. Further large‐scale cohort studies are needed to establish the treatment strategy for PMME.     

Primary malignant melanoma of the esophagogastric junction: A case report

Rationale:Most gastrointestinal melanomas are metastatic from an oculocutaneous primary lesion; however, primary gastrointestinal melanomas have been found in all levels of the gastrointestinal tract. We present the case of Primary malignant melanoma of the esophagus and discuss the diagnostic methods, differentiation from metastatic lesions and treatment options.Patient concerns:A 78-year-old male patient presented with fresh blood vomiting and tarry stools for 1 day.Diagnoses:Esophagogastroduodenoscopy of this patient revealed a tumor ∼4 cm in size at the cardia side of the esophagogastric junction with dark-red and gray pigmentation. Immunohistochemical stains of the biopsy specimens were positive for S-100 and HMB-45, which are specific markers of melanoma.Interventions:Laparotomy with proximal gastrectomy was performed by the surgeon. Histological examination of the surgical specimen revealed the tumor arose from the distal esophagus with invasion of the proximal stomach. Primary malignant melanoma of the esophagus was diagnosed after a full skin and ophthalmic examination and positron emission tomography, which revealed no lesions elsewhere in the body.Outcomes:No tumor recurrence was noted at the 1-year follow-up.Lessons:Primary malignant melanoma of the esophagus is an extremely rare but highly aggressive tumor. The special pattern of pigmentation should be recognized while performing endoscopy. Early detection and radical resection of the tumor are critical to ensure favorable outcomes.     

Primary malignant melanoma of the esophagus

A case of primary malignant melanoma of the esophagus is reported, followed by a review of the literature. The clinical presentation of this uncommon tumor is similar to esophageal carcinoma and the preoperative diagnosis may be difficult. A total esophagectomy is the treatment of choice. The prognosis remains poor despite aggressive treatment.     

食管、贲门异时性重复癌1例

食管、贲门异时性重复癌临床少见,本例贲门癌术后11年出现食管癌,与长期胃食管反流损伤食管黏膜有关.提醒临床医生注意.     

Successful treatment of primary pulmonary melanoma

Presented is a rare case of a primary melanoma of the lung in an 89 year old male patient. Primary melanoma of the lung has been previously reported in the English literature in about 30 patients. Surgical resection either with lobectomy of pneumonectomy and a lymph node dissection has been shown to be the best chance of long term survival. This is the oldest patient on record where surgical resection was successful.     

Anorectal malignant melanoma: preoperative usefulness of magnetic resonance imaging

Magnetic resonance imaging (MRI) findings in three patients with primary anorectal malignant melanoma are described. Two patients had melanotic and one had amelanotic anorectal melanoma. The findings of MRI with a pelvic coil and an endorectal coil were consistent with pathologic findings. MRI with a pelvic coil demonstrated the melanotic component as high signal intensity on T1-weighted imaging. MRI with a pelvic coil and an endorectal coil was useful for staging anorectal melanoma. This article describes the initial report of the use of an endorectal coil for malignant melanoma of the anorectum.     

A case of primary malignant melanoma of the esophagus with long-term survival

Primary malignant melanoma of the esophagus is uncommon, and its prognosis is poor compared to that of cutaneous malignant melanoma. Here we describe a case of primary malignant melanoma of the esophagus with a long-term survival. A 52-year-old woman received an upper gastrointestinal endoscopy and an upper gastrointestinal series for a dull back pain and dysphagia. A pigmented polypoid tumor in the esophagus was discovered and diagnosed pathologically as a malignant melanoma on the biopsied specimen. After effective chemotherapy with cisplatin (CDDP), the patient underwent surgical operation. A subtotal esophagectomy with three-field lymph node dissection was performed through a right thoracotomy. No distant metastasis including liver and lung was found, and histopathological examination revealed no lymph node metastasis. Postoperatively, six courses of chemotherapy with CDDP were performed. The patient has been alive without any problems for more than 11 years postoperatively.