鼻腔鼻窦恶性黑色素瘤临床病理分析

发布时间：2018-10-22 09:45

【摘要】：目的:探讨鼻腔鼻窦恶性黑色素瘤(SMMM)的临床病理特点、鉴别诊断、治疗与预后。方法:回顾性分析有完整随访资料的18例SMMM的临床病理资料。全部患者均行手术治疗,其中单纯手术5例,手术联合术后放疗4例,手术联合术后化疗4例,手术联合术后化、放疗5例。术后均进行1~7年随访。结果:12例死于肿瘤复发或远处转移,6例存活。6例术后复发;5例术后出现颈淋巴结转移,其中3例行颈淋巴结清扫术,2例因无手术指征而行放、化疗。3例出现远处转移,肝、肺、脑转移各1例。结论:SMMM临床少见,恶性度高,尚需结合免疫组织化学与多种肿瘤进行鉴别。CT及MRI影像学检查有助于了解病变范围及性质。鼻内镜下或鼻内镜辅助下手术切除SMMM,疗效确切,但必须严格选择适应证。
[Abstract]:Objective: to investigate the clinicopathological features, differential diagnosis, treatment and prognosis of malignant melanoma of nasal cavity and paranasal sinus. Methods: the clinicopathological data of 18 cases of SMMM with complete follow-up data were retrospectively analyzed. All patients were treated by operation, including 5 cases of simple operation, 4 cases of surgery combined with postoperative radiotherapy, 4 cases of surgery combined with postoperative chemotherapy, 5 cases of surgery combined with postoperative chemotherapy and 5 cases of radiotherapy. All patients were followed up for 1 ~ 7 years. Results: 12 cases died of tumor recurrence or distant metastasis, 6 cases survived, 6 cases recurred, 5 cases developed cervical lymph node metastasis, 3 cases underwent neck lymph node dissection, 2 cases received radiotherapy, 3 cases had distant metastasis, 3 cases had lung metastasis. Brain metastasis occurred in 1 case each. Conclusion: SMMM is rare in clinic and has a high degree of malignancy. It is necessary to differentiate many kinds of tumors with immunohistochemistry. CT and MRI imaging are helpful to understand the extent and nature of the lesions. Endoscopic or endoscopic resection of SMMM, is effective, but indications must be strictly selected.
【作者单位】：四川省人民医院耳鼻咽喉科;四川省人民医院病理科;
【分类号】：R739.62

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