Beenken S, Byers R, Smith J L, Goepfert H, Shallenberger R
Department of Head and Neck Surgery, University of Texas M. D. Anderson Cancer Center, Houston, TX 77030.
Arch Otolaryngol Head Neck Surg. 1989 Mar;115(3):374-9. doi: 10.1001/archotol.1989.01860270116025.
Desmoplastic (neurotrophic) melanoma is a histologic variant of cutaneous melanoma that has a distinct clinical behavior. To better understand this behavior and to treat the disease more effectively, the medical records of 16 patients treated for this disease over a 12-year period were reviewed. Thirteen patients had head and neck lesions, the ear being a common site. The average thickness of the lesions was 5.75 mm. Six (46.2%) of 13 patients had local recurrence of disease. Only two patients (15.4%) developed regional node metastases. None of the patients with clinically NO desmoplastic melanoma were found to have positive nodes after elective neck dissection, regardless of the thickness of the primary lesion. Wide excision of the primary lesion with frozen section control of surgical margins and careful examination for the presence of perineural invasion is important in determining the extent of surgical resection.
促纤维增生性（神经滋养性）黑色素瘤是皮肤黑色素瘤的一种组织学变体，具有独特的临床行为。为了更好地了解这种行为并更有效地治疗该疾病，我们回顾了12年间接受该疾病治疗的16例患者的病历。13例患者有头颈部病变，耳部是常见部位。病变的平均厚度为5.75毫米。13例患者中有6例（46.2%）出现疾病局部复发。只有2例患者（15.4%）发生区域淋巴结转移。无论原发灶厚度如何，临床上无淋巴结转移的促纤维增生性黑色素瘤患者在选择性颈部清扫术后均未发现阳性淋巴结。对原发灶进行广泛切除并通过冰冻切片控制手术切缘，仔细检查是否存在神经周围浸润，对于确定手术切除范围很重要。
