Tseng William W, Doyle Judy A, Maguiness Sheilagh, Horvai Andrew E, Kashani-Sabet Mohammed, Leong Stanley P L
UCSF, Surgery, 513 Parnassus Avenue, S-321, San Francisco, CA 94143-0470, USA.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.07.2009.2073. Epub 2009 Oct 5.
Two patients with giant, 8 cm and 19 cm melanomas of the upper extremity, respectively, are presented and discussed. Both patients had neglected their tumours and sought medical attention only after the appearance of distressing symptoms (for example, bleeding). Palpable lymph nodes were found on physical examination but no evidence of distant metastases was noted on imaging studies despite such enormous primary tumours. Both patients underwent aggressive treatment, including complete surgical resection of the primary tumour and ipsilateral axillary lymph node dissection. One patient had no evidence of local recurrence, but developed metastatic disease at 6 months follow-up. The other patient developed local recurrence and distant metastases within 2 months of resection.
本文介绍并讨论了两名分别患有上肢巨大黑色素瘤的患者，肿瘤大小分别为8厘米和19厘米。两名患者均忽视了自身肿瘤，仅在出现令人痛苦的症状（如出血）后才寻求医疗救治。体格检查发现可触及的淋巴结，但尽管原发性肿瘤巨大，影像学检查未发现远处转移的证据。两名患者均接受了积极治疗，包括原发性肿瘤的完整手术切除和同侧腋窝淋巴结清扫。一名患者无局部复发证据，但在随访6个月时出现转移性疾病。另一名患者在切除后2个月内出现局部复发和远处转移。
