Hudson D A, Krige J E, Strover R M, King H S
Department of Plastic Surgery, University of Cape Town, South Africa.
Br J Plast Surg. 1990 Sep;43(5):608-11. doi: 10.1016/0007-1226(90)90129-n.
Twelve patients with primary melanoma of the external ear were treated during a 10-year period. Ten patients were males. Median melanoma depth was 2.1 mm and seven patients had lesions deeper than 2 mm. Eight of 12 lesions were either Clark level IV or V. Six patients had wedge excisions of the primary lesion and all developed recurrent disease (local: three). Six patients underwent wide excision and none developed local recurrence. All patients with primary disease less than 2 mm are alive. Only two of seven patients with lesions deeper than 2 mm have survived. The definitive excision for melanoma of the ear should encompass wide margins despite the cosmetic consequences. Lesser procedures inevitably lead to local recurrence. Melanoma deeper than 2 mm penetration on the ear in our series had a poor prognosis.
在10年期间，共治疗了12例原发性外耳黑色素瘤患者。其中10例为男性。黑色素瘤的中位深度为2.1毫米，7例患者的病变深度超过2毫米。12处病变中有8处为Clark分级IV级或V级。6例患者对原发性病变进行了楔形切除，均出现了复发性疾病（局部复发：3例）。6例患者接受了广泛切除，均未出现局部复发。所有原发性疾病小于2毫米的患者均存活。7例病变深度超过2毫米的患者中只有2例存活。尽管会影响美观，但耳部黑色素瘤的确定性切除应包括广泛的切缘。较小的手术不可避免地会导致局部复发。在我们的系列研究中，耳部黑色素瘤穿透深度超过2毫米的预后较差。
