Warso M, Gray T, Gonzalez M
Department of Surgical Oncology, University of Illinois at Chicago 60612, USA.
J Hand Surg Am. 1997 Mar;22(2):354-60. doi: 10.1016/S0363-5023(97)80178-5.
Melanomas of the hand are relatively rare, and much confusion exists concerning their pathology and treatment. We reviewed our experience with 39 patients diagnosed with melanoma of the hand. The data were categorized by site, histology, and type of treatment. Most primaries were on the digits, with a few tumors arising on the palm. The most common histology was superficial spreading melanoma, even in the subungual location. Acral lentiginous melanoma accounted for only 8 of 39 cases. Most patients could be treated without radical amputations, even for melanomas on the digits. Review of our patients emphasized the need for early diagnosis. Biopsy of all unexplained pigmented lesions on the hands can lead to early diagnosis, relatively nondeforming treatment, and good survival.
手部黑色素瘤相对少见,其病理学及治疗方面存在诸多混淆之处。我们回顾了39例诊断为手部黑色素瘤患者的治疗经验。数据按部位、组织学类型及治疗方式进行分类。多数原发灶位于手指,少数肿瘤发生于手掌。最常见的组织学类型为浅表扩散型黑色素瘤,即使在甲下部位亦是如此。肢端雀斑样痣型黑色素瘤仅占39例中的8例。多数患者无需进行根治性截肢,即使是手指上的黑色素瘤。对我们患者的回顾强调了早期诊断的必要性。对手部所有无法解释的色素沉着病变进行活检可实现早期诊断、相对不造成畸形的治疗及良好的生存率。