Zikry Joseph, Chapman Lance W, Korta Dorota Z, Smith Janellen
*All authors are affiliated with the Department of Dermatology, UC Irvine Medical Center, Irvine, California.
Dermatol Surg. 2017 Jun;43(6):765-770. doi: 10.1097/DSS.0000000000001072.
Primary male genital melanomas are rare. Of these, scrotal melanoma is the least common, and is unfortunately often detected late in the disease course.
To assess the clinical presentation, treatment modalities, and outcome of scrotal melanoma to aid clinician management.
Systematic literature review of PubMed, yielding 23 cases, of which 20 met the inclusion criteria.
Although previously thought to have the best outcome of genitourinary melanomas, scrotal melanomas are associated with high mortality and late presentation. Scrotal melanoma presented as Stage I/II disease 18.75% of the time, Stage III 56.3% of the time, and Stage IV 25% of the time, whereas typical cutaneous melanoma presents as Stage I/II disease 84% of the time, Stage III 8% of the time, and Stage IV 4% of the time. Half of patients experienced recurrence of their disease. All patients who presented with metastases to distant organs died.
Small sample size. Few cases described a Breslow's depth making it difficult to draw conclusions on tumor thickness and survival outcome.
Scrotal melanoma is rare, aggressive, and is often caught late in the disease course. The authors encourage dermatologists to educate patients and destigmatize genital lesions to increase the likelihood of earlier detection and better patient outcomes.
原发性男性生殖器黑色素瘤较为罕见。其中，阴囊黑色素瘤最为少见，不幸的是，该病往往在病程晚期才被发现。
评估阴囊黑色素瘤的临床表现、治疗方式及预后，以协助临床医生进行管理。
对PubMed进行系统文献综述，共获得23例病例，其中20例符合纳入标准。
尽管阴囊黑色素瘤曾被认为是泌尿生殖系统黑色素瘤中预后最佳的，但它却与高死亡率和晚期发病相关。阴囊黑色素瘤表现为I/II期疾病的占18.75%，III期的占56.3%，IV期的占25%；而典型的皮肤黑色素瘤表现为I/II期疾病的占84%，III期的占8%，IV期的占4%。半数患者出现疾病复发。所有出现远处器官转移的患者均死亡。
样本量小。很少有病例描述Breslow深度，因此难以就肿瘤厚度和生存结果得出结论。
阴囊黑色素瘤罕见、侵袭性强，且常在病程晚期才被发现。作者鼓励皮肤科医生对患者进行教育，消除对生殖器病变的污名化，以提高早期发现的可能性和改善患者预后。
