Gutman M, Inbar M, Chaitchik S, Merhav A, Pausner D, Skoznik Y, Ilie B, Rozin R R, Klausner J M
Department of Surgery, Tel Aviv Sourasky Medical Center, Israel.
Eur J Surg Oncol. 1992 Aug;18(4):307-12.
Primary malignant melanoma occurring in mucous membranes is uncommon. Of 410 patients with malignant melanoma, 14 (3.4%) had their primary tumour located in mucosal membranes. Five of the tumours were in the mucosal lining of the head and neck, five in the gastrointestinal tract mucosa and four in the female genitalia. Eight of the tumours were ulcerated, necrotic and deeply invasive. The most common histological subtype was acral lentiginous melanoma. Surgical resection of the primary tumour was performed in 10 patients. In the other four, surgery was not feasible, and they were treated by irradiation and immunotherapy. Six patients underwent regional lymph node dissection. In four of them, regional metastases were found. Chemotherapy was given to seven patients for widespread metastases. Nine patients (64%) died of metastatic melanoma within 2 years. The remaining five patients are alive after 3 to 8 years. It appears that mucosal membrane melanoma is a distinct variant of the disease due to both its aggressive biological behaviour and its relative inaccessibility for surgical removal, and may therefore be classified separately.
发生于黏膜的原发性恶性黑色素瘤并不常见。在410例恶性黑色素瘤患者中，有14例（3.4%）的原发性肿瘤位于黏膜。其中5例肿瘤位于头颈部黏膜，5例位于胃肠道黏膜，4例位于女性生殖器。8例肿瘤有溃疡、坏死且浸润较深。最常见的组织学亚型是肢端雀斑样痣型黑色素瘤。10例患者对原发性肿瘤进行了手术切除。另外4例患者无法进行手术，接受了放疗和免疫治疗。6例患者进行了区域淋巴结清扫，其中4例发现有区域转移。7例有广泛转移的患者接受了化疗。9例患者（64%）在2年内死于转移性黑色素瘤。其余5例患者在3至8年后仍存活。黏膜黑色素瘤似乎是该疾病的一种独特变体，因其具有侵袭性生物学行为且手术切除相对困难，因此可能需要单独分类。
