Ribero Simone, Pampena Riccardo, Bataille Veronique, Moscarella Elvira, Thomas Luc, Quaglino Pietro, Potenza Concetta, Van Akkooi Alexander C J, Testori Alessandro, Nathan Paul, Puig Susana, Zalaudek Iris, Argenziano Giuseppe, Longo Caterina
Section of Dermatology, Medical Sciences Department, University of Turin, Turin, Italy.
Dermatology. 2016;232(6):704-707. doi: 10.1159/000453592. Epub 2017 Jan 5.
How to deal with melanoma of unknown primary (MUP) origin is a debated topic in the literature.
We performed a worldwide survey to inquire what clinical and investigational workup is performed as well as the physicians' perception of this disease.
A questionnaire was sent via mail to clinicians involved in melanoma care from December 2015 to April 2016 using the International Dermoscopy Society website.
119 physicians from 47 different countries answered the questionnaire. The most reported examination was skin examination followed by CT and/or PET scans. All the participants declared asking about previous excisions of skin lesions with 81% of them asking for a histopathological slide review of previous biopsies. Half of the participants checked for a possible vitiligo phenomenon that may explain regression of the primary lesion. BRAF, cKIT, and GNAQ mutations were screened by 32% of participants. The majority of participants (76%) applied the same treatment protocols for MUP as patients with known primary melanomas of the same AJCC stage.
Strong heterogeneity was found between physicians dealing with MUP. Thus, a consensus document should be strongly encouraged.
如何处理原发灶不明的黑色素瘤（MUP）是文献中一个有争议的话题。
我们进行了一项全球调查，以了解进行了哪些临床和研究性检查，以及医生对这种疾病的看法。
2015年12月至2016年4月期间，通过国际皮肤镜协会网站向参与黑色素瘤治疗的临床医生邮寄了一份问卷。
来自47个不同国家的119名医生回答了问卷。报告最多的检查是皮肤检查，其次是CT和/或PET扫描。所有参与者都表示会询问之前皮肤病变的切除情况，其中81%的人要求对之前活检的组织病理切片进行复查。一半的参与者检查是否存在可能解释原发灶消退的白癜风现象。32%的参与者筛查了BRAF、cKIT和GNAQ突变。大多数参与者（76%）对MUP采用与相同AJCC分期的已知原发性黑色素瘤患者相同的治疗方案。
在处理MUP的医生之间发现了强烈的异质性。因此，强烈鼓励制定一份共识文件。
