Trayanova E, Trayanov I, Chokoeva A, Tchernev G
Akush Ginekol (Sofiia). 2015;54(6):42-8.
Malignant melanoma is the most aggressive form of skin cancer showing extremely high metastatic rate and leading to high levels of lethality. The continually growing incidence of malignant melanoma in the world and his difficult early diagnosis are the occasion for numerous studies. The individual risk for malignant transformation of melanocytes is determined by a number of etiologic factors--endogenous and exogenous. Ultraviolet radiation has a leading role in the group of exogenous factors. Within the group of endogenous factors, besides the well-known photo type skin, as well as genes mutations, are added and the sex hormones, with their significant prognostic importance. The differences, which are observed in the progression and prognosis of malignant melanoma in pre- and postmenopausal women, and men, have defined this cutaneous neoplasma as hormone-dependent tumor. We present two seemingly similar clinical cases of 52 year old woman and 53-year-old man diagnosed with malignant melanomas, developed on the basis of pigmented lesions located on the upper back, as we attempt a comparative analysis on etiopathogenetic factors led to radically different course and prognosis of the disease in these two patients.
恶性黑色素瘤是最具侵袭性的皮肤癌形式，具有极高的转移率并导致高致死率。全球恶性黑色素瘤发病率持续上升且早期诊断困难，引发了大量研究。黑素细胞发生恶性转化的个体风险由多种病因决定——包括内源性和外源性因素。紫外线辐射在外源性因素中起主要作用。在内源性因素中，除了众所周知的光敏感型皮肤以及基因突变外，性激素也被纳入其中，且具有重要的预后意义。绝经前和绝经后女性以及男性的恶性黑色素瘤在进展和预后方面存在差异，这已将这种皮肤肿瘤定义为激素依赖性肿瘤。我们呈现了两名看似相似的临床病例，一名52岁女性和一名53岁男性，均被诊断为恶性黑色素瘤，肿瘤基于位于上背部的色素沉着病变发展而来，我们尝试对导致这两名患者疾病进程和预后截然不同的病因学因素进行比较分析。
