Chanthasenanont Athita, Nantakomon Tongta, Kintarak Jutatip, Vithisuvanakul Nophadol, Pongrojpaw Densak, Suwannarurk Komsun
J Med Assoc Thai. 2015 Apr;98 Suppl 3:S126-31.
Metastatic malignant melanomas to the uterus are extremely rare; to our knowledge, no more than 13 cases have been reported to date.
A 44-years-old multigravida woman presented with a black and irregular surface mass at medial aspect of left thigh. There was also an enlarged left groin node. Wide excision with lymph node dissection revealed malignant melanoma. Further examination found a huge pelvic mass with left deep vein thrombosis consequent by pressure effect. Chest and complete abdominal computed tomography revealed an enlarged, fibroid uterus with pressure effect at left common iliac vein. A total abdominal hysterectomy and bilateral adnexectomy were performed. Intra-operative finding was scattered hyperpigment spots at surface of the uterus and its tumor Histopathological report showed metastatic malignant melanoma involving myometrium and uterine serosa. Diagnosis of stage IV malignant melanoma (uterine metastasis) was achieved. The patient was counseled about her diagnosis, stage, prognosis and further treatment.
Uterine metastatic malignant melanoma was a rare condition. This report represents the first case of a cutaneous malignant melanoma involving a uterine leiomyoma in Thailand.
子宫转移性恶性黑色素瘤极为罕见；据我们所知，迄今为止报道的病例不超过13例。
一名44岁的多产妇女性，左大腿内侧出现一个表面黑色且不规则的肿块。左腹股沟淋巴结也肿大。广泛切除并进行淋巴结清扫后发现为恶性黑色素瘤。进一步检查发现一个巨大的盆腔肿块，因压迫导致左下肢深静脉血栓形成。胸部和全腹部计算机断层扫描显示子宫增大且为纤维瘤，对左髂总静脉有压迫作用。遂行全腹子宫切除术和双侧附件切除术。术中发现子宫表面有散在的色素沉着斑及其肿瘤。组织病理学报告显示转移性恶性黑色素瘤累及子宫肌层和子宫浆膜。确诊为IV期恶性黑色素瘤（子宫转移）。已向患者告知其诊断、分期、预后及进一步治疗情况。
子宫转移性恶性黑色素瘤是一种罕见疾病。本报告是泰国首例皮肤恶性黑色素瘤累及子宫平滑肌瘤的病例。
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