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一例诊断和治疗11年后外阴黏膜侵袭性恶性黑色素瘤转移的罕见病例

A Rare Case of Invasive Malignant Melanoma Metastasis in the Vulvar Mucosa 11 Years After Diagnosis and Treatment.

作者信息

Thuremella Bhavya, Schultz Robyn, Mohan Sukanya, Castilla Maria

机构信息

General Surgery, Dr. Kiran C. Patel College of Osteopathic Medicine, NSU (Nova Southeastern University) Florida, Fort Lauderdale, USA.

General Surgery, Dr. Kiran C. Patel College of Osteopathic Medicine, NSU (Nova Southeastern University) Florida, Tampa, USA.

出版信息

Cureus. 2024 Jun 12;16(6):e62259. doi: 10.7759/cureus.62259. eCollection 2024 Jun.

DOI:10.7759/cureus.62259
PMID:39006602
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11245045/
Abstract

Mucosal melanoma is rare and the occurrence of an invasive malignant melanoma metastasis 11 years post-initial diagnosis is equally uncommon. This is a case of a 66-year-old woman with a history of bilateral vulvar invasive melanoma, who presented with an enlarging inguinal mass with associated tenderness upon palpation. After a right inguinal excisional lymph node biopsy, the pathological findings determined the final diagnosis as metastatic melanoma. To the best of our knowledge, this is the first report of vulvar mucosal melanoma metastasis greater than 10 years after initial diagnosis and treatment in the English language. This case discusses how treatment options for metastatic mucosal melanoma pose a challenge in such cases where follow-up for medical care is lacking. It also highlights the need for further preventative techniques and research directed towards screening techniques, staging guidelines, and treatment options for mucosal melanoma.

摘要

黏膜黑色素瘤较为罕见,在初次诊断11年后发生侵袭性恶性黑色素瘤转移的情况同样不常见。这是一例66岁女性患者,有双侧外阴侵袭性黑色素瘤病史,她因腹股沟肿物增大且触诊时有压痛前来就诊。在进行右侧腹股沟切除性淋巴结活检后,病理结果确诊为转移性黑色素瘤。据我们所知,这是英文文献中首例初次诊断和治疗10年以上后出现外阴黏膜黑色素瘤转移的报告。本病例讨论了转移性黏膜黑色素瘤的治疗方案在缺乏医疗随访的此类病例中如何构成挑战。它还强调了针对黏膜黑色素瘤的筛查技术、分期指南和治疗方案,需要进一步的预防技术和研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a559/11245045/b745e4abbc27/cureus-0016-00000062259-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a559/11245045/fff36026be65/cureus-0016-00000062259-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a559/11245045/04cd0c7e3bd7/cureus-0016-00000062259-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a559/11245045/b745e4abbc27/cureus-0016-00000062259-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a559/11245045/fff36026be65/cureus-0016-00000062259-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a559/11245045/04cd0c7e3bd7/cureus-0016-00000062259-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a559/11245045/b745e4abbc27/cureus-0016-00000062259-i03.jpg

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本文引用的文献

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Cutaneous Melanoma versus Vulvovaginal Melanoma-Risk Factors, Pathogenesis and Comparison of Immunotherapy Efficacy.皮肤黑色素瘤与外阴阴道黑色素瘤——危险因素、发病机制及免疫治疗疗效比较
Cancers (Basel). 2022 Oct 19;14(20):5123. doi: 10.3390/cancers14205123.
2
Melanoma: Staging and Follow-Up.黑色素瘤:分期与随访
Dermatol Pract Concept. 2021 Jul 1;11(Suppl 1):e2021162S. doi: 10.5826/dpc.11S1a162S. eCollection 2021 Jul.
3
Vulvar and Vaginal Melanomas-The Darker Shades of Gynecological Cancers.外阴和阴道黑色素瘤——妇科癌症中更隐匿的类型
Biomedicines. 2021 Jun 30;9(7):758. doi: 10.3390/biomedicines9070758.
4
Vulvar Melanoma: Molecular Characteristics, Diagnosis, Surgical Management, and Medical Treatment.外阴黑色素瘤:分子特征、诊断、手术治疗和内科治疗。
Am J Clin Dermatol. 2021 Sep;22(5):639-651. doi: 10.1007/s40257-021-00614-7. Epub 2021 Jun 14.
5
Primary malignant melanomas of the female lower genital tract: clinicopathological characteristics and management.女性下生殖道原发性恶性黑色素瘤:临床病理特征与治疗
Am J Cancer Res. 2020 Dec 1;10(12):4017-4037. eCollection 2020.
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Primary melanoma of the oral cavity: A multi-institutional retrospective analysis in Brazil.口腔原发性黑色素瘤:巴西多机构回顾性分析。
Med Oral Patol Oral Cir Bucal. 2021 May 1;26(3):e379-e386. doi: 10.4317/medoral.24240.
7
SOX10 is as specific as S100 protein in detecting metastases of melanoma in lymph nodes and is recommended for sentinel lymph node assessment.SOX10 在检测淋巴结中黑色素瘤转移方面与 S100 蛋白一样具有特异性,建议用于前哨淋巴结评估。
Eur J Cancer. 2020 Sep;137:175-182. doi: 10.1016/j.ejca.2020.06.037. Epub 2020 Aug 8.
8
Anti-PD-1 and Novel Combinations in the Treatment of Melanoma-An Update.抗程序性死亡蛋白1(Anti-PD-1)及其新型联合疗法治疗黑色素瘤的最新进展
J Clin Med. 2020 Jan 14;9(1):223. doi: 10.3390/jcm9010223.
9
Current state of melanoma diagnosis and treatment.黑色素瘤的诊断与治疗现状。
Cancer Biol Ther. 2019;20(11):1366-1379. doi: 10.1080/15384047.2019.1640032. Epub 2019 Aug 1.
10
Impact of initial stage on metastatic melanoma survival.初始阶段对转移性黑色素瘤生存的影响。
Melanoma Res. 2019 Jun;29(3):281-288. doi: 10.1097/CMR.0000000000000526.