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头颈部手术中的黏膜恶性黑色素瘤:6例患者的回顾性研究及文献复习

Mucosal malignant melanomas in head and neck surgery: a retrospective study of six patients and review of the literature.

作者信息

Kruse Astrid L D, Riener Marc O, Graetz Klaus W, Luebbers Heinz-Theo

机构信息

Clinic for Craniomaxillofacial and Oral Surgery, University Hospital Zurich, Frauenklinikstr. 24, 8091, Zürich, Switzerland.

出版信息

Oral Maxillofac Surg. 2010 Sep;14(3):143-7. doi: 10.1007/s10006-010-0207-z.

Abstract

INTRODUCTION

Of all malignant processes of the oral mucosa, 0.5% are malignant melanomas. Because of late diagnosis, pattern of growth, close proximity to the bone (particularly in palatinal localizations), and the correlated infiltration, malignant melanomas have a bad prognosis.

PATIENTS AND METHODS

In this retrospective study, six cases of patients with oral mucosal malignant melanoma are evaluated, and a critical review of the literature is presented. The female to male proportion was 1:1 with an average age of 60.2 years; all patients were treated between January 1999 and July 2007. A neck dissection was performed on two patients because of clinically positive lymph nodes; one patient received interleukin 2 therapy, and three patients received postoperative radiotherapy. Two male patients died.

CONCLUSIONS

We recommend biopsy on every growing lesion, pigmented or nonpigmented, for the required diagnosis and, in cases of malignant melanoma, wide excision as a second step. Neck dissections should be performed in patients with clinically positive lymph nodes. Concerning interleukin 2 therapy, further studies should be performed in order to evaluate a routine application.

摘要

引言

在口腔黏膜的所有恶性病变中,恶性黑色素瘤占0.5%。由于诊断较晚、生长方式、与骨组织距离较近(尤其是腭部病变)以及相关浸润情况,恶性黑色素瘤预后较差。

患者与方法

在这项回顾性研究中,对6例口腔黏膜恶性黑色素瘤患者进行了评估,并对相关文献进行了批判性综述。男女比例为1:1,平均年龄60.2岁;所有患者均在1999年1月至2007年7月期间接受治疗。2例因临床检查发现淋巴结阳性而行颈部淋巴结清扫术;1例患者接受白细胞介素2治疗,3例患者接受术后放疗。2例男性患者死亡。

结论

我们建议对每一个生长性病变,无论有无色素沉着,均进行活检以明确诊断,对于恶性黑色素瘤患者,第二步应进行广泛切除。对于临床检查发现淋巴结阳性的患者应行颈部淋巴结清扫术。关于白细胞介素2治疗,应进一步开展研究以评估其常规应用价值。

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