Piura B, Meirovitz M, Kedar I
Department of Obstetrics and Gynecology, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Eur J Obstet Gynecol Reprod Biol. 1998 Oct;81(1):83-5. doi: 10.1016/s0301-2115(98)00156-0.
Vulvar malignant melanoma with deep vertical penetration of the tumor and involvement of regional lymph nodes carries a very poor prognosis. The case of a 25-year-old woman with a history of a Breslow depth 6.0 mm and Clark Level IV primary vulvar malignant melanoma, involving the anterior part of the left labium major, 1 cm from the clitoris, is reported. The patient had undergone a left radical hemivulvectomy and bilateral groin dissection. There were two of thirteen superficial left groin nodes containing metastatic melanoma. The patient had been treated postoperatively with an allogeneic specific anti-melanoma vaccine in combination with high-dose cimetidine and has survived without disease for more than five years. To the best of our knowledge this is the first case report in the literature of active specific immunotherapy with allogeneic vaccine in vulvar malignant melanoma. This case illustrates that the behavior of malignant melanoma, including vulvar malignant melanoma, is unpredictable and active specific immunotherapy with allogeneic vaccine may have a role in the postoperative treatment of high risk vulvar malignant melanoma.
肿瘤深度垂直浸润且累及区域淋巴结的外阴恶性黑色素瘤预后极差。本文报告了一例25岁女性患者，其原发性外阴恶性黑色素瘤的 Breslow 深度为6.0 mm，Clark 分级为IV级，病变位于左大阴唇前部，距阴蒂1 cm。患者接受了左侧根治性半外阴切除术及双侧腹股沟淋巴结清扫术。左侧腹股沟浅淋巴结13个中有2个含有转移性黑色素瘤。患者术后接受了同种异体特异性抗黑色素瘤疫苗联合大剂量西咪替丁治疗，已无病生存超过五年。据我们所知，这是文献中首例关于外阴恶性黑色素瘤采用同种异体疫苗进行主动特异性免疫治疗的病例报告。该病例表明，包括外阴恶性黑色素瘤在内的恶性黑色素瘤的行为是不可预测的，同种异体疫苗主动特异性免疫治疗可能在高危外阴恶性黑色素瘤的术后治疗中发挥作用。
