Dunbar S F, Marks L B, Sober A J, Rosenberg A, Suit H D
Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston.
J Am Acad Dermatol. 1994 Aug;31(2 Pt 1):216-9. doi: 10.1016/s0190-9622(94)70150-4.
A possible relation between cutaneous melanoma and connective tissue tumors has been described.
After the observation that a group of our patients had both cutaneous melanoma and a soft tissue sarcoma, we elected to review this formally. Eleven patients with both diagnoses were identified and are described.
A computer search through the Medical Records Department and the Tumor Registry of the Massachusetts General Hospital identified seven men and four women with the diagnoses of melanoma and malignant bone or soft tissue sarcoma. The medical records and pathology specimens of all tumors were reviewed.
In three patients, the two tumors were diagnosed within 1 year of each other, in seven, the diagnosis of melanoma was made first, and in one, melanoma was diagnosed after the connective tissue lesion. The interval between the two diagnoses ranged up to 13 years. Although the locations and types of melanoma were typical, some of the connective tissue tumors were unusual; there were two sacral chordomas. In two instances, the melanoma and connective tissue tumor were anatomically close; the sarcoma developed at the edge of the resection of the prior melanoma in one patient. None of the tumors developed in previously irradiated tissues, and in no instance did the second tumor appear to be caused by the therapy received for the first. None of the patients had a family history of melanoma. Four patients had other cancers in addition to the melanoma and connective tissue tumor.
Although these patients were seen in a referral center, it is our impression (based on the total number of patients with connective tissue tumors seen and the incidence of melanoma in the general population) that observing 11 patients with both types of tumors is greater than would be expected by chance.
皮肤黑色素瘤与结缔组织肿瘤之间可能存在关联已被描述。
在观察到我们的一组患者同时患有皮肤黑色素瘤和软组织肉瘤后，我们决定对此进行正式回顾。确定并描述了11例患有这两种诊断的患者。
通过麻省总医院病历部和肿瘤登记处进行计算机检索，确定了7名男性和4名女性患有黑色素瘤以及恶性骨或软组织肉瘤的诊断。对所有肿瘤的病历和病理标本进行了回顾。
3例患者中，两种肿瘤在彼此1年内被诊断；7例中，首先诊断出黑色素瘤；1例中，黑色素瘤在结缔组织病变后被诊断。两次诊断之间的间隔长达13年。尽管黑色素瘤的部位和类型是典型的，但一些结缔组织肿瘤并不常见；有2例骶骨脊索瘤。在2例中，黑色素瘤和结缔组织肿瘤在解剖学上相邻；1例患者的肉瘤发生在前次黑色素瘤切除边缘。没有肿瘤发生在先前接受过放疗的组织中，且在任何情况下，第二种肿瘤似乎都不是由第一种肿瘤所接受的治疗引起的。所有患者均无黑色素瘤家族史。4例患者除黑色素瘤和结缔组织肿瘤外还患有其他癌症。
尽管这些患者是在转诊中心就诊的，但我们的印象是（基于所见到的结缔组织肿瘤患者总数以及一般人群中黑色素瘤的发病率），观察到11例患有这两种肿瘤的患者的情况超出了偶然预期。
