Jaluvka V, Weitzel H K, Endrikat J
Frauenklinik und Poliklinik, Freien Universität Berlin im Klinikum Steglitz.
Zentralbl Gynakol. 1994;116(7):433-40.
In a 16 year old patient a superficially spreading malignant melanoma had been excised from the left temple. Ten years later, she represented with lower abdominal pain. On examination cystic adnexal masses were found and median laparotomy was performed. Intraoperatively bilateral polycystic, dark-coloured ovarian tumors were found, each measuring about 10 x 10 x 10 cm. Hysterectomy with bilateral salpingo-oophorectomy and resection of the great omentum was performed. Uterus and ovaries weighed 3.480 g. At microscopic examination large metastases of a pigmented melanoblastoma were found in both ovaries. Two months after surgery she succumbed to multiple cerebral metastases. For primary ovarian melanoma radical surgery with lymphonodectomy is mandatory. The operation is to be followed by immuno- and chemotherapy. In case of metastatic melanoma of the ovaries individual decisions concerning the extent of the surgical procedure are to be made. In any case, however, bilateral salpingo-oophorectomy should be performed, preferably combined with hysterectomy.
一名16岁患者的左颞部浅表扩散性恶性黑色素瘤已被切除。10年后，她因下腹部疼痛前来就诊。检查发现附件有囊性肿块，遂行正中剖腹术。术中发现双侧多囊性、深色卵巢肿瘤，每个肿瘤大小约为10×10×10厘米。进行了子宫切除术、双侧输卵管卵巢切除术和大网膜切除术。子宫和卵巢重3480克。显微镜检查发现双侧卵巢有色素沉着性黑素母细胞瘤的大量转移灶。手术后两个月，她死于多发性脑转移。对于原发性卵巢黑色素瘤，必须进行根治性手术并清扫淋巴结。术后应进行免疫治疗和化疗。对于卵巢转移性黑色素瘤，应就手术范围做出个体化决策。然而，无论如何都应进行双侧输卵管卵巢切除术，最好联合子宫切除术。
