Stewart W R, Gelberman R H, Harrelson J M, Seigler H F
J Bone Joint Surg Am. 1978 Jul;60(5):645-9.
Sixteen hundred and seventy-seven melanoma patients were treated at Duke University Medical Center from 1956 to 1976. Osseous metastases were more common than previously reported and occurred in 116 patients (6.9 per cent), most often in the axial skeleton. Diagnosis was made by roentgenogram, bone scan, or both in the symptomatic patient. Seventy-five patients sustained pathological fractures, most of which were successfully treated conservatively. Nine of the ten patients with neurological symptoms were improved by laminectomy. The grave prognosis for melanoma patients with osseous metastases (mean survival, 3.6 months) led to conservatism even for an impending pathological fracture. Unstable pathological fractures of long bones were treated by internal fixation and irradiation.
1956年至1976年期间，1677例黑色素瘤患者在杜克大学医学中心接受了治疗。骨转移比先前报道的更为常见，116例患者（6.9%）出现骨转移，最常发生在中轴骨骼。有症状的患者通过X线片、骨扫描或两者进行诊断。75例患者发生病理性骨折，其中大多数经保守治疗成功。10例有神经症状的患者中，9例通过椎板切除术病情得到改善。黑色素瘤骨转移患者的预后严重（平均生存期3.6个月），即使对于即将发生的病理性骨折也采取保守治疗。长骨不稳定病理性骨折采用内固定和放疗治疗。
