Kim Jae Hwan, Jeong Se Yeong, Shin Jae Bin, Ro Ki Woong, Seo Soo Hong, Son Sang Wook, Kim Il-Hwan
Department of Dermatology, College of Medicine, Korea University, Seoul, Korea.
Ann Dermatol. 2009 May;21(2):171-3. doi: 10.5021/ad.2009.21.2.171. Epub 2009 May 31.
The acral regions of the limbs of Asians are predisposed to develop malignant melanoma, but giant-sized acral melanoma has not been previously reported in the Asian population. Giant-sized melanoma implies aggressive tumor invasion and so it is more difficult to achieve a therapeutic cure. A 56-year-old woman presented with a giant acral melanoma of the left thumb with concomitant bone destruction and axillary lymph node metastasis. The initial lesion was a subungual black macule on the left thumb that had grown into a giant 7.0x4.0x3.5 cm-sized melanoma over a 3 year period. The left thumb was amputated and the axillary lymph nodes were completely dissected. During the ensuing 3 months, she underwent adjuvant treatment with interferon-alpha-2a. The interesting feature of this case is that the large melanoma mass of this patient, which was accompanied with adjacent bone destruction and lymph node metastasis, had developed rapidly from a small black macule in the nail matrix, and this black macule was suspected to be a subungual melanoma.
亚洲人的四肢末端易患恶性黑色素瘤，但此前亚洲人群中尚未报道过巨型肢端黑色素瘤。巨型黑色素瘤意味着肿瘤侵袭性强，因此更难实现治愈性治疗。一名56岁女性患者，其左拇指患有巨型肢端黑色素瘤，并伴有骨质破坏和腋窝淋巴结转移。最初的病变是左拇指的甲下黑斑，在3年时间里发展成了一个巨大的7.0×4.0×3.5厘米大小的黑色素瘤。左拇指被截肢，腋窝淋巴结被彻底清扫。在随后的3个月里，她接受了α-2a干扰素辅助治疗。该病例的有趣之处在于，该患者的巨大黑色素瘤肿块伴有相邻骨质破坏和淋巴结转移，它是从甲床的一个小黑斑迅速发展而来的，而这个黑斑被怀疑是甲下黑色素瘤。
