Schneider L A
Klinik für Dermatologie und Dermatochirurgie, Helios Klinik Rottweil, Krankenhausstr 30, 78628, Rottweil, Deutschland.
Hautarzt. 2017 Feb;68(2):103-110. doi: 10.1007/s00105-016-3915-y.
Melanoma diagnosed during pregnancy is a rare clinical case presentation which must be mastered. In the absence of guidelines for this clinical challenge, we performed a review of the literature and provide a practical guideline on how to manage such rare clinical cases based on our clinical experience. Expecting mothers require adequate counselling and explanation of all therapeutic options as they take responsibility for more than their own lives. However, they should be guided through the process of diagnostic and therapeutic measures in a potentially life-threatening situation. Pregnancy itself is no reason to withhold any type of necessary melanoma surgery. Perioperative management, however, requires certain adjustments in order to comply with this special situation. If indicated, even adjuvant and palliative systemic therapy need to be given to the patient, but they also have to be adapted to the specific circumstances as data is still sparse, especially for the new first and second line therapies with antibodies and targeted molecules.
孕期诊断出黑色素瘤是一种罕见的临床病例表现,必须加以掌握。由于缺乏应对这一临床挑战的指南,我们对文献进行了回顾,并根据临床经验提供了一份关于如何处理此类罕见临床病例的实用指南。准妈妈们需要得到充分的咨询,并对所有治疗方案有所了解,因为她们肩负的责任不止关乎自己的生命。然而,在这种可能危及生命的情况下,应引导她们完成诊断和治疗措施的过程。怀孕本身并非拒绝任何必要的黑色素瘤手术的理由。不过,围手术期管理需要进行某些调整,以适应这种特殊情况。如果有指征,即使是辅助性和姑息性全身治疗也需要给予患者,但由于数据仍然稀少,特别是对于使用抗体和靶向分子的新型一线和二线治疗,这些治疗也必须根据具体情况进行调整。