Di Martino Marcello, García Sanz Iñigo, Mora-Guzmán Ismael, de la Hoz Rodríguez Ángela
Department of General and Digestive Surgery, Hospital Universitario de la Princesa, Madrid, Spain.
BMJ Case Rep. 2017 May 22;2017:bcr2016218681. doi: 10.1136/bcr-2016-218681.
Metastatic melanoma to adrenal gland are very infrequent, being generally associated with additional evidence of systemic disease and, consequently, with short-term survival. However, the prognosis and the therapeutic management vary depending on some important oncological features. Long-term survival rates have been described after complete resection of metastatic disease. Here, we report the case of a woman aged 41 years diagnosed with a cutaneous melanoma on the right side of her paravertebral region, level III of Clark, in 2002, who underwent surgical excision of the tumour with negative margins and a negative sentinel node. She posteriorly developed pulmonary metastasis in 2006 and 2009, both resected with curative intention and in 2013, she was diagnosed with an adrenal metastasis. Therefore, she was submitted to an uneventful right laparoscopic adrenalectomy. The pathology report described metastasis of a cutaneous melanoma, negative for BRAF mutation. The patient is actually disease-free after 30 months of follow-up.
肾上腺转移性黑色素瘤非常罕见,通常与全身性疾病的其他证据相关,因此生存期较短。然而,预后和治疗管理因一些重要的肿瘤学特征而异。已有报道称,转移性疾病完全切除后可实现长期生存率。在此,我们报告一例41岁女性病例,该患者于2002年被诊断为椎旁区域右侧的皮肤黑色素瘤,Clark分级为III级,接受了肿瘤切除手术,切缘阴性且前哨淋巴结阴性。她随后在2006年和2009年出现肺转移,均进行了根治性切除,2013年被诊断为肾上腺转移。因此,她接受了顺利的右侧腹腔镜肾上腺切除术。病理报告显示为皮肤黑色素瘤转移,BRAF突变阴性。经过30个月的随访,该患者目前无疾病。