Heenan P J, Ghaznawie M
Department of Pathology, Hasanuddin University, Ujungpandang, Indonesia.
Br J Plast Surg. 1999 Apr;52(3):209-13. doi: 10.1054/bjps.1998.3050.
Local recurrence of melanoma at the primary excision site may imply that the primary excision was incomplete or 'inadequate', and that the recurrence was due to retained primary melanoma cells or occult microsatellites in the adjacent tissue. Pathologists frequently report these tumours in the scar as recurrent or residual melanoma, without further qualification, apparently without considering the possibility that they may be metastases and manifestations of systemic disease. In this study, 17 of 19 cases of locally recurrent melanoma at the primary excision site showed the histological features of metastasis rather than residual incompletely excised primary melanoma. Because the prevention of local recurrence is the main reason given in recommendations for wide excision of melanoma beyond complete excision of the primary tumour itself, it is essential that surgeons and pathologists should classify these neoplasms precisely as either persistent incompletely excised primary melanoma or metastatic melanoma.
黑色素瘤在原发切除部位的局部复发可能意味着原发切除不完全或“不充分”，且复发是由于残留的原发性黑色素瘤细胞或邻近组织中隐匿的微卫星灶所致。病理学家经常将瘢痕中的这些肿瘤报告为复发性或残留性黑色素瘤，未作进一步说明，显然没有考虑到它们可能是转移灶及全身性疾病表现的可能性。在本研究中，19例原发切除部位局部复发的黑色素瘤病例中有17例显示出转移的组织学特征，而非残留的切除不完全的原发性黑色素瘤。由于在黑色素瘤广泛切除建议中，预防局部复发是除了完全切除原发性肿瘤本身之外的主要理由，因此外科医生和病理学家必须准确地将这些肿瘤分类为持续存在的切除不完全的原发性黑色素瘤或转移性黑色素瘤。
