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经阴道镜检查诊断的子宫转移性恶性黑色素瘤。

Metastatic malignant melanoma of the uterus diagnosed by colposcopy.

作者信息

Živadinović Radomir, Mijović Žaklina, Petrić Aleksandra, Popović Jasmina, Vukomanović Predrag, Trenkić Milan, Krtinić Dane

出版信息

Srp Arh Celok Lek. 2016 May-Jun;144(5-6):329-33.

Abstract

INTRODUCTION

Primary and metastatic malignant melanomas represent a rare diagnosis with a small number of described cases. The aggressive nature of the tumor, non-specific symptoms, difficult diagnosis, and no official protocol about the treatment result in poor disease prognosis.

CASE OUTLINE

The authors presented a 41-year-old multigravida patient. She had an operation of malignant melanoma in the occipital area of the head. She went to her gynecologist because of increased pale pink vaginal secretion. Gynecological examination didn’t show any significant abnormalities apart from a slightly enlarged uterus. Papanicolaou test and vaginal secretion examination were normal. Colposcopically, a significant dark brown hyperpigmented area around 1 cm in size was observed on the posterior lip of the cervix, near the orifice and cervical canal, suspicious of melanoma, which was proven on targeted biopsy of the hyperpigmented change on the cervix, and by magnetic resonance imaging of the lesser pelvis. Classic hysterectomy with adnexectomy and regional pelvic lymphadenectomy were performed.

CONCLUSION

This case report pointed out the significance of applying colposcopy in diagnosing suspected metastatic melanoma of the uterine cervix, along with other diagnostic methods and anamnestic data.

摘要

引言

原发性和转移性恶性黑色素瘤是一种罕见的诊断,仅有少数病例报道。肿瘤的侵袭性、非特异性症状、诊断困难以及缺乏关于治疗的官方方案导致疾病预后较差。

病例概述

作者介绍了一名41岁的多产妇患者。她曾接受头部枕部恶性黑色素瘤手术。因淡粉色阴道分泌物增多前往妇科就诊。妇科检查除子宫稍大外未发现任何明显异常。巴氏试验和阴道分泌物检查正常。阴道镜检查发现,在宫颈后唇靠近宫颈口和宫颈管处有一个大小约1厘米的明显深褐色色素沉着区,怀疑为黑色素瘤,经宫颈色素沉着改变的靶向活检及盆腔磁共振成像证实。实施了经典的子宫切除术加附件切除术及区域盆腔淋巴结清扫术。

结论

本病例报告指出了阴道镜检查在诊断疑似子宫颈转移性黑色素瘤中的重要性,以及其他诊断方法和既往史数据的重要性。

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