腰背部巨型先天性黑色素痣一例报告

发布时间：2018-05-11 04:43

本文选题：巨型先天性黑色素痣 + 深部浸润　；参考：《中国修复重建外科杂志》2014年04期

【摘要】：目的总结1例腰背部巨型先天性黑色素痣(简称巨痣)的特点、治疗方法及疗效。方法 2013年7月收治1例13岁腰背部巨痣女性患儿,入院检查示黑斑上至第12肋平面,下至臀部上份,两侧达腋前线;表面无毛发,凹凸不平,颜色不均匀,质地偏硬。全麻下行腰背部巨痣切除联合右侧臀大肌肌瓣(12 cm×8 cm大小)、自体上背部网状刃厚皮片(59 cm×47 cm大小)修复术,术中见巨痣浸润深度达髂骨骨膜,浸润宽度在真皮及以下,超出术前判定范围。结果术后综合病理检查确诊为巨痣,累及皮下组织,有坏死,部分细胞增生活跃。术后20 d创面愈合。术后6个月(2014年1月)随访,创面部分瘢痕形成,未见复发病灶。结论巨痣浸润可深达骨膜,其皮下浸润范围可能超出肉眼所见;因有恶变风险,宜采取手术扩大切除。
[Abstract]:Objective to summarize the characteristics, treatment and curative effect of a case of giant congenital melanoma nevus on the back of the waist and back. Methods in July, 2013, a 13-year-old female patient with giant nevus of waist and back was admitted to our hospital. The examination showed that the black spot was above the 12th rib plane, the lower part was to the superior part of the hip, the two sides reached the front of axillary, the surface was hairless, uneven, uneven in color and hard in texture. Under general anesthesia, the resection of giant nevus of lumbar and back combined with the right gluteus maximus muscle flap was 12 cm 脳 8 cm in size, and the thickness of autogenous upper back reticular skin graft was 59 cm 脳 47 cm in size. It was found that the invasive depth of giant nevus reached to the iliac periosteum during the operation, and the width of the invasion was in the dermis and below. Beyond the range of preoperative judgment. Results the histopathological examination confirmed giant nevus, involving subcutaneous tissue, necrosis and active proliferation of some cells. The wound healed 20 days after operation. Six months after operation (January 2014), partial scar formation was found in the wound, and no recurrent lesions were found. Conclusion the invasion of giant nevus can reach the periosteum and the extent of subcutaneous infiltration may exceed that seen by the naked eye.
【作者单位】：四川大学华西医院烧伤整形科;
【分类号】：R758.51

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