Scala Marco, Gipponi Marco, Queirolo Paola, Mereu Paola, Solari Nicola, Monteghirfo Stefano, Cafiero Ferdinando
S.C. Oncologia Chirurgica, National Cancer Research Institute, Genoa, Italy.
In Vivo. 2006 Jan-Feb;20(1):153-6.
Cryosurgery is safely employed for the treatment of skin precancerous and malignant lesions of the head and neck in selected patients. The case of a 101-year-old female patient with advanced malignant melanoma of the facial skin, undergoing cryosurgery, is reported in order to assess the feasibility and tolerability of the technique, as well as the biological implications of cryosurgical treatment in this specific neoplasm.
A 101-year-old woman, with a large (pT4b N0 M0) cutaneous melanoma of the facial skin on the right cheek, was treated at the Division of Surgical Oncology of the National Cancer Research Institute, Italy, from June to August 2003. The treatment was accomplished by means of serial cryosurgical applications which were performed within three months; the bulk of the lesion was cryotreated with a liquid nitrogen cryoprobe, while the residual disease was treated with a nitrous protoxide cryoprobe, by means of the insertion technique. The treatment was well tolerated, with a good aesthetic result, and the patient is recurrence- and distant-disease-free two years after the initial cryosurgical application.
Cryosurgery is feasible in the treatment of head and neck melanoma, mostly for mucosal melanomas and cutaneous lesions in anatomically critical sites, as well as in high-risk surgical patients. Here, a good aesthetic result was obtained in a very elderly patient with a large cutaneous melanoma of the facial skin, avoiding skin flap transposition for tissue repair and postoperative complications (e.g., serious bleeding or postoperative pain), with a satisfactory functional and oncological outcome at two years.
在特定患者中，冷冻手术可安全用于治疗头颈部皮肤癌前病变和恶性病变。本文报告了一例101岁面部皮肤晚期恶性黑色素瘤女性患者接受冷冻手术的病例，以评估该技术的可行性和耐受性，以及冷冻手术治疗这种特定肿瘤的生物学意义。
一名101岁女性，右脸颊面部皮肤患有巨大（pT4b N0 M0）皮肤黑色素瘤，于2003年6月至8月在意大利国家癌症研究所外科肿瘤学部接受治疗。治疗通过在三个月内进行的系列冷冻手术完成；使用液氮冷冻探头对大部分病变进行冷冻治疗，而残余病灶则通过插入技术使用一氧化二氮冷冻探头进行治疗。治疗耐受性良好，美学效果良好，患者在首次冷冻手术后两年无复发和远处转移。
冷冻手术在头颈部黑色素瘤的治疗中是可行的，主要适用于黏膜黑色素瘤和解剖学关键部位的皮肤病变，以及高风险手术患者。在此，一名患有巨大面部皮肤黑色素瘤的高龄患者获得了良好的美学效果，避免了用于组织修复的皮瓣转移和术后并发症（如严重出血或术后疼痛），两年时功能和肿瘤学结果令人满意。
