Keller H, Hacker R, Stolte M
Innere Abteilung, Kreiskankenhauses Rastatt.
Med Klin (Munich). 1997 Nov 15;92(11):683-5. doi: 10.1007/BF03044826.
The incidence of late, recurrence of malignant melanoma, is a well known, but very rare clinical experience.
We report a case of simultaneous myocardial revascularisation and resection of pulmonary melanoma metastasis. In 1963 an enucleation of the right eye was necessary due to an ocular melanoma. In 1993 the patient suffered acute left heart failure and a 3-vessel disease with severe reduced left ventricular function was diagnosed. Chest X-ray examination revealed a singular pulmonary lesion in the right lower lobe with a diameter of 5.5 cm. Myocardial revascularisation and resection of the pulmonary focus was performed simultaneously without complication. The histological examination documented a pulmonary late recurrence of malignant melanoma. Up to this time (3 years later) the patient is free of cardiac symptoms and there is no evidence of further late recurrence of malignant melanoma.
The appreciable number of patients who, after a disease-free interval of 10 to 20 years, develop a late recurrence of a malignant melanoma, and in particular-as in the present case-a choroidal melanoma, is powerful evidence for a need to keep these patients under lifelong surveillance.
恶性黑色素瘤晚期复发的发生率是一种广为人知但非常罕见的临床情况。
我们报告一例同时进行心肌血运重建和肺黑色素瘤转移灶切除的病例。1963年，因眼部黑色素瘤，右眼进行了眼球摘除术。1993年，患者发生急性左心衰竭，诊断为三支血管病变且左心室功能严重减退。胸部X线检查显示右下叶有一个直径5.5厘米的孤立性肺部病变。同时进行了心肌血运重建和肺部病灶切除，未出现并发症。组织学检查证实为恶性黑色素瘤肺部晚期复发。截至此时（3年后），患者无心脏症状，也没有恶性黑色素瘤进一步晚期复发的迹象。
相当数量的患者在10至20年的无病期后出现恶性黑色素瘤晚期复发，特别是——如本病例——脉络膜黑色素瘤，这有力地证明有必要对这些患者进行终身监测。
