外阴黑色素瘤：20例报告及文献复习
Vulvar melanoma: a report of 20 cases and review of the literature.
作者信息
Wechter Mary Ellen, Gruber Stephen B, Haefner Hope K, Lowe Lori, Schwartz Jennifer L, Reynolds Kevin R, Johnston Carolyn M, Johnson Timothy M
机构信息
Department of Obstetrics and Gynecology, University of Michigan Health System, University of Michigan Comprehensive Cancer Center, Ann Arbor 48109-0314, USA.
出版信息
J Am Acad Dermatol. 2004 Apr;50(4):554-62. doi: 10.1016/j.jaad.2003.07.026.
BACKGROUND
Vulvar melanoma is the second most common vulvar malignancy and represents a significant women's health issue.
OBJECTIVE
To report experience with 21 cases of vulvar melanoma in 20 patients and to review the literature about the condition.
METHODS
Parameters retrospectively reviewed included age at diagnosis, family history of melanoma, location on the vulva, atypical nevi, Breslow depth, ulceration status, histologic pattern, presenting signs and symptoms, and the results of sentinel lymph node biopsy. Molecular characterization of the melanocortin type 1 receptor was performed in 1 patient.
RESULTS
A family history of cutaneous melanoma was present in 15% of cases. The mean Breslow depth was 2.8 mm (range, 0.0-11.0 mm). Ten patients successfully underwent sentinel lymph node biopsy, results of which were positive in 2 (20%). Reported for the first time is that one patient had a germline mutation in the melanocortin type 1 receptor.
CONCLUSION
Vulvar and cutaneous melanoma behave similarly despite their unique pathogeneses. Sentinel lymph node biopsy can be performed successfully for vulvar melanoma.
背景
外阴黑色素瘤是第二常见的外阴恶性肿瘤，是一个重要的女性健康问题。
目的
报告20例患者中21例外阴黑色素瘤的治疗经验，并回顾有关该疾病的文献。
方法
回顾性分析的参数包括诊断时的年龄、黑色素瘤家族史、外阴部位、非典型痣、Breslow深度、溃疡状态、组织学类型、临床表现及体征，以及前哨淋巴结活检结果。对1例患者进行了黑皮质素1型受体的分子特征分析。
结果
15%的病例有皮肤黑色素瘤家族史。平均Breslow深度为2.8mm（范围0.0 - 11.0mm）。10例患者成功接受了前哨淋巴结活检，其中2例（20%）结果为阳性。首次报道1例患者黑皮质素1型受体存在种系突变。
结论
尽管外阴黑色素瘤和皮肤黑色素瘤的发病机制不同，但临床表现相似。外阴黑色素瘤可成功进行前哨淋巴结活检。
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