Banaczek Zbigniew, Ruka Włodzimierz, Bator Monika, Krzyszkowska Izabela
Oddział Ginekologiczno-Połozniczego Wojewódzkiego Szpitala Specjalistycznego w Radomiu.
Przegl Lek. 2006;63(3):169-70.
Cutaneous melanoma is a tumour which has the highest increase of incidence per year. In Poland, the process reaches 10%. In this essay, a case of cutaneus melanoma co-existing with pregnancy was presented. The woman was 36 years old. The neoplasm was diagnosed during the eighth week of her second pregnancy. An excision biopsy of the skin lesion on the back surface of the left shank was carried out. III degree melanoma malignum according to Clark's, and 1,6 mm according to Breslov was diagnosed. During the 35th week of pregnancy, the woman was hospitalized because of threatening premature labour. During her stay at the department, enlarged inguinal lymph nodes were observed. Because of the advanced pregnancy, the patient was qualified to limfadectonomy after labour. In the 38th week of pregnancy, she delivered by spontaneous labour a healthy baby. After two weeks, an inguinal limfadectonomy was carried out. In the histopathological analysis, metastases to lymph nodes were diagnosed. They did not cross the nodular capsules. The patient remains under monthly oncological observation. Eight months after delivery, thirteen months from the removal of the primary lesion, no lesions in the physical examination and other additional examinations have been diagnosed. The accurate evaluation of the pigmented nevus appearance could contribute to the diagnosis of the melanoma in the early stage of progression. Pregnant women, who notice a change in the look of a nevus should be directed to a dermatological consultation.
皮肤黑色素瘤是一种年发病率增长最高的肿瘤。在波兰,这一增长过程达到10%。本文介绍了一例与妊娠并存的皮肤黑色素瘤病例。该女性36岁。在她第二次怀孕的第八周诊断出肿瘤。对左小腿后表面的皮肤病变进行了切除活检。根据克拉克分级为III级恶性黑色素瘤,根据布雷斯洛分级为1.6毫米。在怀孕第35周时,该女性因先兆早产住院。在她住院期间,观察到腹股沟淋巴结肿大。由于怀孕晚期,患者在分娩后接受了腹股沟淋巴结清扫术。在怀孕第38周时,她自然分娩了一个健康的婴儿。两周后,进行了腹股沟淋巴结清扫术。在组织病理学分析中,诊断出有淋巴结转移。转移灶未穿过结节包膜。患者每月接受肿瘤学观察。分娩八个月后,距原发灶切除已有十三个月,体格检查及其他附加检查均未诊断出病变。对色素痣外观的准确评估有助于在黑色素瘤进展的早期阶段做出诊断。注意到痣外观变化的孕妇应前往皮肤科进行咨询。