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无色素性原发性宫颈恶性黑色素瘤:一例病例报告及文献复习

Amelanotic primary cervical malignant melanoma: A case report and review of literature.

作者信息

Duan Jin-Lin, Yang Jing, Zhang Yong-Long, Huang Wen-Tao

机构信息

Department of Pathology, The Affiliated Tongren Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200332, China.

Laboratory of Targeted Therapy and Precision Medicine, Department of Clinical Laboratory, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China.

出版信息

World J Clin Oncol. 2024 Jul 24;15(7):953-960. doi: 10.5306/wjco.v15.i7.953.

Abstract

BACKGROUND

Primary malignant melanoma of the cervix (PMMC) is an extremely rare disease that originates from primary cervical malignant melanoma and frequently represents a challenge in disease diagnosis due to unclarified clinical and histological presentations, particularly those without melanin.

CASE SUMMARY

Here, we report a case of amelanotic PMMC, with a history of breast cancer and thyroid carcinoma. The patient was finally diagnosed by immunohistochemical staining and staged as IB2 based on the International Federation of Gynecology and Obstetrics with reference to National Comprehensive Cancer Network guidelines and was treated with radical hysterectomy, bilateral salpingo-oophorectomy and pelvic lymphadenectomy. She then received combination therapy consisting of immunotherapy with tislelizumab and radiofrequency hyperthermia. She has remained free of disease for more than 1 year.

CONCLUSION

The differential diagnosis process reenforced the notion that immunohistochemical staining is the most reliable approach for amelanotic PMMC diagnosis. Due to the lack of established therapeutic guidelines, empirical information from limited available studies does not provide the rationale for treatment-decision making. By integrating 'omics' technologies and patient-derived xenografts or mini-patient-derived xenograft models this will help to identify selective therapeutic window(s) and screen the appropriate therapeutics for targeted therapies, immune checkpoint blockade or combination therapy strategies effectively and precisely that will ultimately improve patient survival.

摘要

背景

宫颈原发性恶性黑色素瘤(PMMC)是一种极其罕见的疾病,起源于宫颈原发性恶性黑色素瘤,由于临床和组织学表现不明确,尤其是那些无黑色素的情况,在疾病诊断中常常构成挑战。

病例摘要

在此,我们报告一例无黑色素性PMMC病例,患者有乳腺癌和甲状腺癌病史。患者最终通过免疫组化染色确诊,并参照美国国立综合癌症网络指南,根据国际妇产科联盟分期为IB2期,接受了根治性子宫切除术、双侧输卵管卵巢切除术和盆腔淋巴结清扫术。随后,她接受了替雷利珠单抗免疫治疗和射频热疗的联合治疗。她已无病生存超过1年。

结论

鉴别诊断过程强化了这样一种观念,即免疫组化染色是无黑色素性PMMC诊断最可靠的方法。由于缺乏既定的治疗指南,有限的现有研究中的经验信息无法为治疗决策提供依据。通过整合“组学”技术和患者来源的异种移植或微型患者来源的异种移植模型,这将有助于识别选择性治疗窗口,并有效、精确地筛选出适用于靶向治疗、免疫检查点阻断或联合治疗策略的合适治疗方法,最终提高患者生存率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d370/11271727/a00392b69cff/WJCO-15-953-g001.jpg

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