Barton Blair M, Ramsey Tam, Magne Jacqueline M, Worley N Knight
Department of Otolaryngology - Head and Neck Surgery, Tulane University School of Medicine, New Orleans, LA.
University of South Carolina School of Medicine, Columbia, SC.
Ochsner J. 2019 Summer;19(2):181-183. doi: 10.31486/toj.17.0083.
Metastatic melanoma to the mucosa of the upper aerodigestive tract is extremely rare, accounting for <0.6% of known metastasis to the head and neck region. We present a case of delayed metastatic melanoma to the pharyngeal tonsil. A 57-year-old African American female presented for evaluation of a rapidly enlarging unilateral tonsil mass. Three years prior to presentation, she had undergone primary resection of and systemic therapy for cutaneous melanoma on the sole of her right foot. Tonsillectomy confirmed the diagnosis of metastatic melanoma. Because of the poor prognosis of the disease, the patient was referred for palliative chemotherapy but died shortly after beginning treatment. Metastatic melanoma is a rare disease in African Americans, and the presence of metastatic lesions is a significant prognostic indicator for long-term patient survival. Meticulous head and neck examinations should be performed during the follow-up period, and any pigmented lesion should have a high suspicion for metastasis in any patient with a history of cutaneous melanoma.
转移性黑色素瘤累及上呼吸消化道黏膜极为罕见，占已知头颈部转移病例的比例不到0.6%。我们报告一例发生于咽扁桃体的迟发性转移性黑色素瘤病例。一名57岁的非裔美国女性因单侧扁桃体肿物迅速增大前来就诊。就诊前三年，她曾因右足底皮肤黑色素瘤接受了原发灶切除及全身治疗。扁桃体切除术后确诊为转移性黑色素瘤。鉴于该病预后较差，患者被转诊接受姑息化疗，但在开始治疗后不久死亡。转移性黑色素瘤在非裔美国人中是一种罕见疾病，转移病灶的出现是患者长期生存的重要预后指标。在随访期间应仔细进行头颈部检查，对于有皮肤黑色素瘤病史的任何患者，任何色素沉着病变都应高度怀疑有转移。
