Sidoni A, Ottaviani F, Maurizi M
Institute of Pathological Anatomy and Histology, University of Perugia, Italy.
Histol Histopathol. 1987 Jul;2(3):299-306.
Primary malignant melanomas of the nasal cavity are rare, as only 400 cases have been reported to date. The present paper describes two cases recently seen in Caucasian women. The authors point out the difficult clinical diagnosis, as the symptoms are rather aspecific. From the histopathological point of view, diagnosis is easy in the melanotic cases while can show interpretating problems in the amelanotic ones, when melanoma is almost indistinguishable from other malignant neoplasms. A correlation between histological grading and prognosis was not detected, as both cases showed local recurrences within one year after surgery although they were, respectively, of epithelioid and undifferentiated type. While surgery appears to be the choice treatment of the primary lesion, the treatment of cervical metastasis is still disputable. On the whole, most authors think that the role played by radio- and mainly chemo-therapy is still limited and that cervical adenopathies should be treated by a simple lympho-adenectomy rather than by a neck dissection.
鼻腔原发性恶性黑色素瘤很罕见，迄今为止仅报道过400例。本文描述了最近在白人女性中见到的两例病例。作者指出临床诊断困难，因为症状相当不具特异性。从组织病理学角度来看，黑色素性病例的诊断容易，而无黑色素性病例可能会出现解释问题，此时黑色素瘤几乎无法与其他恶性肿瘤区分开来。未检测到组织学分级与预后之间的相关性，因为两例病例在手术后一年内均出现局部复发，尽管它们分别为上皮样和未分化型。虽然手术似乎是原发性病变的首选治疗方法，但颈部转移的治疗仍存在争议。总体而言，大多数作者认为放疗尤其是化疗所起的作用仍然有限，颈部淋巴结肿大应通过简单的淋巴结切除术而非颈部清扫术进行治疗。
