转移性黑色素瘤的胰腺切除术
Pancreatic resection for metastatic melanoma.
作者信息
Nikfarjam M, Evans P, Christophi C
机构信息
Department of Surgery, Melbourne University, Austin Hospital, Melbourne, Victoria, Australia.
出版信息
HPB (Oxford). 2003;5(3):174-9. doi: 10.1080/13651820310015284.
BACKGROUND
The pancreas is an occasional site of metastases from melanoma. It may be the only location of metastatic disease, but more often the melanoma metastasis to other organs as well. Treatment options are somewhat limited, and the role of operative treatment is poorly defined.
CASE OUTLINES
Two patients presenting with abdominal pain were found to have pancreatic lesions. A 45-year-old woman had a pylorus-preserving pancreatoduodenectomy for a mass in the head of pancreas; concurrent liver nodules were treated by segmental liver resection. A 55-year-old man had a total pancreatectomy for multiple pancreatic tumours. Both patients gave a history of ocular melanoma, diagnosed >10 years previously. They had no evidence of malignancy elsewhere. Histology of resected specimens confirmed metastatic melanoma with features consistent with an ocular primary. All resection margins were clear of malignancy, and no lymph node metastases were detected. At 6 months follow-up there were no signs of tumour recurrence.
DISCUSSION
Complete surgical resection offers potential cure in selected patients with metastatic melanoma involving the pancreas, when there is no evidence of widespread disease.
背景
胰腺是黑色素瘤转移的少见部位。它可能是转移性疾病的唯一部位，但黑色素瘤更常同时转移至其他器官。治疗选择有限，手术治疗的作用尚不明确。
病例概述
两名因腹痛就诊的患者被发现有胰腺病变。一名45岁女性因胰头肿块接受了保留幽门的胰十二指肠切除术；同时对肝脏结节进行了肝段切除术。一名55岁男性因多发胰腺肿瘤接受了全胰切除术。两名患者均有眼部黑色素瘤病史，诊断时间超过10年。他们其他部位均无恶性肿瘤证据。切除标本的组织学检查证实为转移性黑色素瘤，特征与眼部原发肿瘤一致。所有切除边缘均无恶性肿瘤，未检测到淋巴结转移。随访6个月时无肿瘤复发迹象。
讨论
对于无广泛疾病证据的胰腺转移性黑色素瘤患者，完整的手术切除有可能治愈部分患者。
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