Osorio Marcela, Moubayed Sami P, Hernandez-Prera Juan, Scott John C, Urken Mark L
Thyroid, Head and Neck Cancer (THANC) Foundation, New York, NY, USA.
Thyroid, Head and Neck Cancer (THANC) Foundation, New York, NY, USA; Department of Otolaryngology - Head and Neck Surgery, Mount Sinai Downtown, New York, NY, USA.
Am J Otolaryngol. 2017 Jul-Aug;38(4):501-504. doi: 10.1016/j.amjoto.2017.04.010. Epub 2017 Apr 21.
Mucosal melanoma of the palatine tonsil is extremely rare. Due to its poor prognosis, primary tonsillar melanoma requires prompt recognition and treatment.
A 62-year-old female presented with a deeply pigmented and exophytic lesion in the left tonsillar fossa. The patient underwent a partial pharyngectomy through a midline labio-mandibulotomy approach along with a left level I-V neck dissection. Reconstruction with a left radial forearm free flap and a pharyngeal constrictor advancement pharyngoplasty was performed.
The patient remains free of disease at eight months after adjuvant proton therapy and eleven months after surgery. To our knowledge, less than thirty cases have been either reported or referenced in the literature since the early 1900's. This report is the first in English literature to compile all reported cases of primary tonsillar melanoma.
Currently, evidence suggests that mucosal melanoma in the palatine tonsil should be treated in the same fashion as other head and neck mucosal melanomas, mindful of the high rates at which locoregional and distant metastases occur.
腭扁桃体黏膜黑色素瘤极为罕见。由于其预后较差，原发性扁桃体黑色素瘤需要及时识别和治疗。
一名62岁女性患者，左侧扁桃体窝有一个色素沉着深且外生性的病变。患者通过中线唇下颌切开术进行了部分咽切除术，并同时进行了左侧Ⅰ-Ⅴ区颈部淋巴结清扫术。采用左桡侧前臂游离皮瓣和咽缩肌推进咽成形术进行重建。
患者在辅助质子治疗8个月后及手术后11个月仍无疾病复发。据我们所知，自20世纪初以来，文献报道或引用的病例不到30例。本报告是英文文献中首次汇编所有已报道的原发性扁桃体黑色素瘤病例。
目前，有证据表明，腭扁桃体黏膜黑色素瘤应与其他头颈部黏膜黑色素瘤采用相同的治疗方式，同时要注意局部区域和远处转移的高发生率。
