Washburn W K, Noda S, Lewis W D, Jenkins R L
Division of Hepatobiliary Surgery and Liver Transplantation, New England Deaconess Hospital, Boston, MA 02215, USA.
Liver Transpl Surg. 1995 Mar;1(2):103-6. doi: 10.1002/lt.500010206.
Primary malignant melanoma of the biliary tract is an obscure entity, with only four previously reported cases. We report two cases involving the common bile duct. A 43-year-old male who underwent a right hepatectomy and excision of the extrahepatic biliary tree for a lesion at the bifurcation of the common bile duct. He remains alive and well 11 months after resection. The second patient is a 45 year old male with obstructive jaundice due to an ampullary lesion. Pancreaticoduodenectomy was performed with no signs of metastatic disease. He is 6 years following resection without evidence of disease. This is an unusual cause of obstructive jaundice and a definitive search for a possible extra-biliary primary should be pursued. In appropriately selected patients without evidence of metastatic disease, resection can potentially afford long-term survival if these lesions are true primary lesions and not metastatic from an undefined primary. However, given the high metastatic potential of melanoma it is unclear whether resection of these lesions results in cure or just effective long-term palliation.
原发性胆道恶性黑色素瘤是一种罕见的疾病，此前仅有4例报道。我们报告2例累及胆总管的病例。一名43岁男性因胆总管分叉处病变接受了右肝切除术及肝外胆道树切除术。切除术后11个月，他仍然健在。第二例患者是一名45岁男性，因壶腹病变导致梗阻性黄疸。行胰十二指肠切除术，未发现转移病灶迹象。切除术后6年，他无疾病证据。这是梗阻性黄疸的一种不寻常病因，应彻底寻找可能的肝外原发性病灶。在没有转移疾病证据的适当选择的患者中，如果这些病变是真正的原发性病变而非未明确原发部位的转移灶，切除有可能带来长期生存。然而，鉴于黑色素瘤的高转移潜能，尚不清楚切除这些病变能否治愈或仅能实现有效的长期姑息治疗。
