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五例老年患者足部恶性黑色素瘤:临床病理特征及治疗结果

Malignant Melanoma of the Foot in Five Elderly Patients: Clinicopathologic Features and Treatment Outcomes.

作者信息

Sharon Jekin J, D G Gokulesh, M Kamalraj

机构信息

General Surgery, Madras Medical College, Chennai, IND.

出版信息

Cureus. 2025 Apr 11;17(4):e82076. doi: 10.7759/cureus.82076. eCollection 2025 Apr.

Abstract

Malignant melanoma, an aggressive neoplasm of melanocytes, remains a leading cause of skin cancer-related deaths globally, with rising incidence among elderly populations. Foot melanomas are often diagnosed at advanced stages due to delayed detection and misdiagnosis. They exhibit poorer outcomes compared to melanomas at other sites. This case series presents five elderly patients (ages 58-80) with malignant melanoma of the foot, detailing their clinicopathological features, treatment strategies, and outcomes. All cases presented with advanced disease, emphasizing the challenges of late diagnosis in this demographic. Histopathological evaluation confirmed nodular, superficial spreading, and acral lentiginous subtypes, with Breslow thicknesses ranging from 1.5 mm to 3.5 cm. Management involved wide local excision, lymph node dissection, and adjuvant chemotherapy in high-risk cases. Recurrence occurred in one patient, underscoring the aggressive nature of the disease. The series highlights the necessity of early detection, multidisciplinary care, and tailored adjuvant therapies to improve outcomes in elderly patients with foot melanoma.

摘要

恶性黑色素瘤是一种侵袭性黑素细胞肿瘤,仍然是全球皮肤癌相关死亡的主要原因,在老年人群中的发病率呈上升趋势。足部黑色素瘤常因检测延迟和误诊而在晚期才被诊断出来。与其他部位的黑色素瘤相比,它们的预后较差。本病例系列介绍了5例(年龄58 - 80岁)足部恶性黑色素瘤老年患者,详细阐述了他们的临床病理特征、治疗策略和预后。所有病例均表现为晚期疾病,突出了该人群晚期诊断的挑战。组织病理学评估证实为结节型、浅表扩散型和肢端雀斑样痣型亚型,Breslow厚度范围为1.5毫米至3.5厘米。治疗包括广泛局部切除、淋巴结清扫,高危病例采用辅助化疗。1例患者出现复发,突显了该疾病的侵袭性。该系列强调了早期检测、多学科护理以及定制辅助治疗对于改善老年足部黑色素瘤患者预后的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/896a/12066876/1a8fe8dfd215/cureus-0017-00000082076-i01.jpg

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