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单阶段食管切除术和肺叶切除术后发生食管黑色素瘤并肺转移的长期存活者：病例报告及文献综述

A long-term survivor with esophageal melanoma and pulmonary metastasis after single-stage esophagectomy and lobectomy: Case report and literature review.

作者信息

Zhao Tian, Kong Feng-Wei, Wang Heng, Liu Dong, Wang Chun-Ying, Luo Jin-Hua, Zhang Miao, Wu Wen-Bin

机构信息

Department of Thoracic Surgery, Xuzhou Central Hospital Affiliated to Southeast University Department of General Surgery, Xuzhou Infectious Disease Hospital, Xuzhou Department of Thoracic Surgery, Jiangsu Province Hospital, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

出版信息

Medicine (Baltimore). 2017 May;96(21):e7003. doi: 10.1097/MD.0000000000007003.

DOI:10.1097/MD.0000000000007003
PMID:28538413
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5457893/
Abstract

RATIONALE

The optimal therapeutic regimen for primary malignant melanoma of the esophagus (PMME) need to be further elucidated. Besides, the efficacy of surgery for PMME with remote metastasis is uncertain for its rarity.

PATIENT CONCERNS

Herein a previously healthy patient was admitted for dysphagia and fatigue, without significant weight loss.

DIAGNOSES

The pathological and molecular tests revealed his diagnosis of BRAF-mutant, advanced PMME with localized pulmonary metastasis.

INTERVENTIONS

Single-stage Ivor-Lewis esophagectomy and lobectomy were performed successfully, followed by 4 cycles of conventional chemotherapy, and concurrent high-dose interferon lasting for 1 year.

OUTCOMES

The patient survived without logo-regional recurrence or remote metastasis during the follow up of two and a half years up to now.

LESSONS

Timely resection of localized primary and metastatic lesions might deliver a chance to obtain better prognosis for selected PMME patients; however, high-quality trials with longer follow-up are needed.

摘要

理论依据

食管原发性恶性黑色素瘤（PMME）的最佳治疗方案有待进一步阐明。此外，由于PMME伴远处转移病例罕见，手术对其疗效尚不确定。

患者情况

本文报道一名既往健康的患者，因吞咽困难和乏力入院，无明显体重减轻。

诊断

病理和分子检测显示其诊断为BRAF突变型晚期PMME伴局限性肺转移。

干预措施

成功实施一期Ivor-Lewis食管切除术和肺叶切除术，随后进行4个周期的传统化疗，并同时给予高剂量干扰素治疗1年。

结果

截至目前，在长达两年半的随访中，该患者无局部区域复发或远处转移存活。

经验教训

对于部分PMME患者，及时切除局限性原发性和转移性病变可能带来获得更好预后的机会；然而，需要开展随访时间更长的高质量试验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8026/5457893/2ab29d52d185/medi-96-e7003-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8026/5457893/9c16ebdc45f4/medi-96-e7003-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8026/5457893/572c7c926e68/medi-96-e7003-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8026/5457893/2ab29d52d185/medi-96-e7003-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8026/5457893/9c16ebdc45f4/medi-96-e7003-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8026/5457893/572c7c926e68/medi-96-e7003-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8026/5457893/2ab29d52d185/medi-96-e7003-g003.jpg

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