Kozakiewicz Jacek, Gierlotka Agata, Barzyk-Arciszewska Anna
Oddział Laryngologii Wojewódzkiego Szpitala Specjalistycznego Nr 4 w Bytomiu, Poland.
Otolaryngol Pol. 2012 Nov-Dec;66(6):424-7. doi: 10.1016/j.otpol.2012.05.009. Epub 2012 May 7.
Melanoma is one of the most malignant neoplasm. Mostly it is located in skin but also can appear in every place where melanocytes are present. Approximately 25% of all of these tumours is located in head and neck region probably because of intensive sun exposure of the skin. The case of the 44-year-old, male patient with malignant melanoma of the external ear was shown in this paper. The patient was asymptomatic and diagnosed accidentally. The suspicion of metastatic lymph nodes of neck was based on CT and ultrasonography examination. The patient was treated by surgical excision (total resection of the right auricle) with one centimeters of free margins. Additionally elective neck's lymph nodes dissection was performed. The histopathological evaluation has shown radical excision of stage II (Clark's scale) malignant melanoma of the ear with negative margins and without metastatic lymph nodes of the neck. The patient was not qualified to radiotherapy by oncologist. No evidence of local recurrences or distant metastasis was detected during a 3 years follow-up period. The epidemiology, clinical and pathological classification of the tumour, diagnostic problems and therapy were described. The prognosis of melanoma depends mostly on the thickness of the tumour but also on level of invasion and presence of ulceration.
黑色素瘤是最恶性的肿瘤之一。它大多位于皮肤，但也可能出现在存在黑素细胞的任何部位。所有这些肿瘤中约25%位于头颈部区域，这可能是由于该部位皮肤受阳光强烈照射所致。本文展示了一名44岁男性外耳道恶性黑色素瘤患者的病例。该患者无症状，是偶然被诊断出来的。颈部转移性淋巴结的怀疑基于CT和超声检查。患者接受了手术切除（右耳廓全切除），切缘有1厘米的安全距离。此外还进行了选择性颈部淋巴结清扫。组织病理学评估显示，耳部II期（克拉克分级）恶性黑色素瘤已根治性切除，切缘阴性，颈部无转移性淋巴结。肿瘤学家认为该患者不适合放疗。在3年的随访期内未发现局部复发或远处转移的迹象。文中描述了该肿瘤的流行病学、临床和病理分类、诊断问题及治疗方法。黑色素瘤的预后主要取决于肿瘤的厚度，但也取决于浸润程度和溃疡的存在情况。
