Barr L C, Skene A I, Fish S, Thomas J M
Department of Surgery, Royal Marsden Hospital, London, UK.
Br J Surg. 1994 Jan;81(1):64-5. doi: 10.1002/bjs.1800810121.
The preauricular lymph nodes are frequently the first site of metastatic disease from primary malignant melanoma of the upper two-thirds of the face or the anterior scalp. For these patients, or those with adjacent metastatic nodal disease, the prognosis is poor. The median survival of 13 such patients presented was 2 years, with two long-term survivors at 4 and 6 years. Palliative surgery can, however, prevent uncontrolled locoregional disease. Patients with palpable preauricular and cervical node disease should be treated by facial nerve-preserving parotidectomy and radical neck dissection. When no cervical nodes are palpable in patients with preauricular node metastasis, peroperative jugulodigastric node biopsy and frozen-section histopathological examination are useful to select patients for radical neck dissection.
耳前淋巴结常常是面部上三分之二或头皮前部原发性恶性黑色素瘤转移疾病的首个部位。对于这些患者，或那些伴有相邻转移性淋巴结疾病的患者，预后很差。所呈现的13例此类患者的中位生存期为2年，有2例长期存活者分别为4年和6年。然而，姑息性手术可以预防局部区域疾病失控。有可触及的耳前和颈部淋巴结疾病的患者应接受保留面神经的腮腺切除术和根治性颈清扫术。当耳前淋巴结转移患者未触及颈部淋巴结时，术中颈内静脉二腹肌淋巴结活检和冰冻切片组织病理学检查有助于选择进行根治性颈清扫术的患者。
