上腭恶性黑色素瘤广泛转移1例报道

资料患者,男,53岁.于2003年6月自觉进食时上腭不适,咽痛而就诊于秦皇岛市第一医院.查体:左上腭可见大小约6.0cm×6.0cm暗红色肿物,活检病理示:上腭恶性黑色素瘤.于7月2日行放疗:放疗量5000cGy,200cGy/次,共25天,放疗期间给予罗扰素300万UIH qod.放疗结束后即于8月1日复查CT示:(1)左侧硬腭软组织肿较前缩小,现局部仍可见软组织肿,约1.6cm×2.0cm(横截面),并有强化.肿物缩小.(2)硬腭骨质未见破坏.(3)左侧上颌窦炎症较前好转.     

脊髓原发恶性黑色素瘤1例报道

黑色素瘤主要发生在面部及肢体皮肤,神经系统少见,发生在脊髓内极为少见,脊髓原发性恶性黑色素瘤更为罕见.本文报道1例. 1临床资料 患者男性,56岁.患者无明显诱因逐渐出现腰背痛4个月,自下向上发展,劳动、活动时加剧.双下肢麻木无力,逐渐走路困难1个月.大小便失禁半个月.在当地医院就诊,X线检查,诊断意见为骨质增生.入院后临床考虑"神经系统病变",无明确诊断.予以导尿、脱水及神经营养剂治疗.排尿好转,其他症状无变化.1996年1月25日转来我院,门诊以"椎管内肿瘤"收入院.平素体健,无眼疾、皮肤病,无结核、肿瘤,无免疫功能减退、遗传性疾病,无外伤、手术史.入院后查体:皮肤无瘀点瘀斑,无皮疹、色素痣.心肺未见异常.脊柱无畸形,胸11水平压痛及叩击痛.双侧腹股沟以下皮肤痛觉触觉基本消失.肌张力减低,肌力显著下降.深浅反射未引出,无病理反射.X线:胸腰椎退行性变.MRI检查:胸11水平脊髓稍增粗,蛛网膜下腔变窄.脊髓段内显现异常信号,T1显示肿瘤增强的高信号,T2为不均匀低信号.增强后,病灶轻度增强.诊断意见为:下段胸椎脊髓占位性病变,考虑"胶质瘤".     

肺原发性恶性黑色素瘤1例报告

肺恶性黑色素瘤绝大多数为转移性的 ,原发性恶性黑色素瘤 (ＰｒｉｍａｒｙＭａｌｉｇｎａｎｔＭｅｌａｎｏｍａｏｆｔｈｅＬｕｎｇ,ＰＭＭＬ)则很罕见。据文献记载 ,符合ＰＭＭＬ诊断标准者共 33例。我们报告 1例有尸检材料证实的ＰＭＭＬ ,并复习文献 ,对其诊断、鉴别诊断、组织发生及预后进行讨论。病例报告 :男性 ,72岁 ,咯血痰 1个月入院。ＣＴ检查 :左肺下叶背段结节样致密影 ,边缘毛糙 ,密度不均。给予抗炎、抗结核治疗 1个月后复查阴影有增大趋势 ,因高度怀疑肺癌行左肺下叶切除术。术后病理诊断 :左肺下叶背段恶性黑色素瘤 ,建议检…     

胃恶性黑色素瘤1例报道

恶性黑色素瘤在我国发病率较低,胃恶性黑色素瘤尤为少见,现报道1例如下.     

胃恶性黑色素瘤1例报道

恶性黑色素瘤在我国发病率较低，胃恶性黑色素瘤尤为少见，现报道1例如下。     

喉癌并皮肤恶性黑色素瘤1例

1　病例介绍患者 ,男 ,77岁。声嘶 2月 ,纤维喉镜检查 :右声带前中 1/ 3处见约 2 cm×2 cm不规则菜花状肿物 ,声带固定。取材活检病理报告示喉高分化鳞状细胞癌而行喉癌根治术 ,术后患者拒绝化疗。 2年后患者面颊部及上腹部分别出现约2 cm× 2 cm、2 cm× 1.5 cm黑斑 ,压之不褪     

口腔粘膜原发性恶性黑色素瘤的临床病理分析

对１６例口腔粘膜原发性恶性黑色素瘤进行了临床病理及免疫组织化学分析，结果表明，本组病例占同期全身恶性黑色素瘤的１０．２％（１６／１５６）发病年龄３０～６６岁，平均４６．３岁，男女之比为１．２９：１。９例（５６．３％）于发病前口腔粘膜黑斑病史，本组发生于牙龈，牙槽粘膜９例（５６．３％）上腭部６例（３７．５％）。除ＨＥ染色外，还进行了Ｓ－１００蛋白及ＨＭＢ－４５的免疫组织化学染色，阳性率分别为１００％     

食管原发性恶性黑色素瘤1例报道并文献复习

目的:探讨食管原发性恶性黑色素瘤（primary malignant melanoma of the esophagus，PMME）的病理形态学特点、诊断、鉴别诊断和预后等。方法:观察和分析1例食管原发性恶性黑色素瘤的病理形态学特征，免疫表型，并进行文献复习。结果:食管原发性恶性黑色素瘤以进行性吞咽困难为主要症状。镜下肿瘤细胞排列呈弥漫片状或巢团状，可见多量黑色素沉积；瘤细胞体积较大，形态多样，卵圆形、梭形或多角形，胞质丰富红染，细胞核大，可见明显嗜酸性核仁，部分细胞核偏位，核分裂易见。周围鳞状上皮基底层及上皮间质交界处黑色素及吞噬色素的细胞明显增多，巢状或层状分布。肿瘤侵至黏膜下层，无淋巴结转移。免疫组化弥漫表达 Vimentin、HMB45及S100，而CKpan等上皮标记阴性。结论:食管原发性恶性黑色素瘤是一种罕见的食管恶性肿瘤。恶性程度高，预后差。免疫组化有助于其诊断，需要与低分化鳞状细胞癌等其它食管恶性肿瘤相鉴别。     

口腔恶性黑色素瘤四例远期随访观察

口腔原发性恶性黑色素瘤极少见 ,约占全部恶性黑色素瘤的 0 .2 %～ 0 .8%。由于口腔恶性黑色素瘤比口腔癌更易转移和侵袭周围组织 ,故其预后很差 ,死亡率高 ,5年存活率仅为 15 %～ 38% [1] 。我科 1984年 4月～ 1994年 8月收治 4例 ,远期随访观察均存活 5年以上 ,现报告如下。一、临床资料男 3例 ,女 1例 ,年龄 48～ 6 0岁。病程半年～ 5 7年。上唇 1例 ,上颌 2例 ,腮腺转移 1例。病变部位及范围 :1例上唇恶性黑色素瘤患者于 5 7年前右上唇生长黑痣 ,近 1年多逐渐增大 ,检查见右上唇粘膜有 4ｃｍ× 1.5ｃｍ黑斑 ,皮肤见1.5ｃｍ× 1.5ｃｍ黑…     

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.     

Malignant Melanoma in an HIV-Infected Man: A Case Report and Literature Review

Malignant Melanoma in an HIV-infected Man: A Case Report and Literature Review

Although it is not proven by causative association, several studies indicate that patients with acquired immune deficiency syndrome (AIDS) have a high risk for developing cutaneous malignancies, especially lymphoma and Kaposi's sarcoma. Other malignant cutaneous lesions seen in this patient population include basal-cell carcinoma, squamous-cell cancer, Bowen's disease, and rarely, maligtiant melanoma. We review the clinical course of a human immunodeficiency virus (HTV)-infected man with a superficial spreading melanoma of the scapula treated with wide local excision. Ten years later, he was diagnosed as having metastatic and widespread disease. By placing our patient's experience in context with other case reports, we sought to determine whether malignant melanoma in the HIV-infected population presents atypically or has a more aggressive natural history. The appearance of malignant melanoma in homosexual men may be coincidental or reflective of the expanding spectrum of HTV-associated diseases. Of the 22 patients reported to have malignant melanoma and HIV, approximately one-third had metastatic disease at the time of initial examination, and those with a decreased CD4⁺ cell count were most likely to have systemic symptoms. Melanomas among patients with HIV infection were often atypical in appearance, being multiple or metastatic, as is the case in other well-defined immunosuppressed groups. Further epidemiological and clinical studies are required to determine whether melanoma occurs more frequently or is more likely to metastasize in persons with HTV disease. Laboratory investigators must also concentrate on those factors in the setting of HIV disease that may contribute to melanocyte activation. Our patient's fulminant clinical course should alert clinicians to carefully evaluate patients with HIV infection and unusual pigmented cutaneous lesions, or who have a prior history of malignant melanoma.     

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。     

Amelanotic Anorectal Malignant Melanoma: Case Report with Immunohistochemical Study and Literature Review

Epithelioid cell tumors presenting in the gastrointestinal tract are uncommon, but when they arise, arriving at a correct diagnosis is important. We report a case of anal malignant melanoma in an 82-year-old man who microscopically showed an epithelioid malignant tumor simulating a gastrointestinal stromal tumor. C-kit stain and Melan-A were diffusely and strongly positive, while HMB-45 was focally positive. This case illustrates the potential pitfall of relying on a single antibody or inadequate panel of immunohistochemical stains to confirm the diagnosis. We recommend to apply an adequate immunohistochemical panel which includes S-100 protein, HMB-45 and Melan-A in order to make an accurate diagnosis, and discuss the differential diagnosis and surgical treatment modalities.Key Words: Malignant melanoma, Rectum, Anus, Immunohistochemistry, Gastrointestinal stromal tumor     

Treatment with Ipilimumab: A Case Report of Complete Response in a Metastatic Malignant Melanoma Patient

Introduction

Over the past year, 3 agents have been approved for the treatment of melanoma by the Food and Drug Administration. These include pegylated interferon α-2b for stage III melanoma, vemurafenib for unresectable or metastatic melanoma with BRAF V600E mutation, and ipilimumab for unresectable or metastatic melanoma.

Case Presentation

We present here the case of a 65-year-old Caucasian male diagnosed with advanced melanoma in April 2011 and treated with ipilimumab (Yervoy^®), a monoclonal antibody targeting cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4), as second-line treatment after progression with dacarbazine, for (wild-type BRAF) metastatic melanoma. The patient was referred to us for several painful lumps on his right arm. A biopsy of one of them revealed melanoma. CT and PET scans did not show any other lesions or a primary site. The patient was started on first-line chemotherapy with dacarbazine 850 mg/m² on day 1, every 3 weeks. After 3 cycles, the patient showed disease progression with an increase in size of the skin metastasis. Second-line treatment was started with ipilimumab 3 mg/kg on day 1, every 3 weeks. At the end of the treatment, after 4 cycles, we documented a complete clinical response with total resolution of the skin metastasis. At the time of writing this paper, our patient had finished his treatment more than 9 months earlier and is still in complete remission.

Conclusion

This is a paradigmatic case where, despite extensive metastatic disease, treatment with ipilimumab has confirmed its efficacy. It is still an open question why only a minority of patients have such a remarkable response, and further trials are warranted to address this important question.Key words: Melanoma, Ipilimumab, Complete response     

气管恶性淋巴瘤1例

患者,男性,74岁,因“咳嗽、气急6个月余,痰中带血2个月”于2002年6月2日入院。患者5年前以“右腹股沟非霍奇金淋巴瘤反复发作”在上海医科大学附属肿瘤医院先后以CHOP为主方案化疗20周期,1~2个月1次,化疗后病灶完全消失。6个月前无明显诱因下出现咳嗽、气急,CT扫描示:纵隔淋巴结肿大,右肺门区肿块,右肺上叶阻塞性炎症。复以“非霍奇金淋巴瘤”予CHOP方案化疗一周期,症状完全缓解,后未行其他治疗及随访。2个月前出现咳嗽伴痰中带血,入院后查体:卡氏评分70分,浅表淋巴结未及,右肺呼吸音稍弱,可及少许哮鸣音,其余未见明显阳性体征。复查CT…