Pföhler C, Vogt T, Müller C S L
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HNO. 2015 Jul;63(7):523-34; quiz 535-6. doi: 10.1007/s00106-015-0024-7.
About 15% of all cutaneous melanomas develop in the head and neck region. Mucosal melanomas are rare and represent only 1% of all melanomas, however, most frequently, these are located in the nose, the paranasal sinuses and the oral cavity. Visual diagnosis and reflected-light microscopy are relevant for the evaluation of melanoma-suspect lesions. Histological investigation of resected tumors need special skills of the histopathologist and includes in case of high-risk tumors investigations of mutations in the tumor tissue concerning NRAS, BRAF and KIT. The risk of lymphatic or hematogeneous spread rises with increasing tumor thickness and the presence of further prognostic risk factors such as ulceration of the primary tumor or the presence of mitoses within the tumor.
所有皮肤黑色素瘤中约15%发生于头颈部区域。黏膜黑色素瘤较为罕见，仅占所有黑色素瘤的1%，然而，这些黑色素瘤最常见于鼻子、鼻窦和口腔。视觉诊断和反射光显微镜检查对于评估疑似黑色素瘤的病变很重要。对切除肿瘤进行组织学检查需要组织病理学家具备特殊技能，对于高危肿瘤，还包括对肿瘤组织中NRAS、BRAF和KIT基因突变的检测。随着肿瘤厚度增加以及存在其他预后危险因素，如原发肿瘤溃疡或肿瘤内有丝分裂，淋巴或血行转移的风险会升高。
