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相關文獻
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題名 | 原發性鼻黏膜黑色素瘤--二病例報告=Primary Mucosal Melanoma in the Nasal Cavity: Report of Two Cases |
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作者 | 王成平; 張逸良; 葉德輝; | 書刊名 | 慈濟醫學 |
卷期 | 15:1 2003.02[民92.02] |
頁次 | 頁69-74 |
分類號 | 416.871 |
關鍵詞 | 鼻腔; 黏膜黑色素瘤; 鼻出血; Nasal cavith; Mucosal melanoma; Epistaxis; |
語文 | 中文(Chinese) |
中文摘要 | 原發性鼻黏膜黑色素瘤是一種罕見的鼻部惡性腫瘤,僅佔全部惡性黑色素瘤的1%。其臨床症狀以單側鼻塞或鼻出血為主。病理診斷以陽性的S-100及HMB-45免疫組織生化染色為主,並應區分原發或轉移性病變。由於腫瘤的生物特性迥異於一般常見的皮膚惡性黑色素瘤,因此預後極差。本文報告二例原發性鼻黏膜黑色素瘤。症狀上,均主訴鼻塞以及自發性鼻出血。鼻內視鏡檢查發現鼻腔內有多發性易出血的黑色腫瘤。全身檢查顯示無頸部淋巴與遠處轉移。於是二例均接受廣泛性切除,並接受術後的放射線治療。目前其中一名病患追蹤二年無復發跡象。但另一名患者於術後一年發生肺部轉移死亡。由於診斷不易以及預後不佳,即使只是鼻塞或鼻出血這類常見症狀,都後小心檢查。尤其發現鼻內黑色病變者,都要接受病理檢查,以期早期診斷,提高存活率。 |
英文摘要 | Primary mucosal melanoma in the nasal cavity is rare sinonsal malignancy, representing less than 1% of all melanoma. Unilateral nasal obstruction and intermittent epsitaxis are the most common symptoms. Immunohistochemical stains, such as S-100 and HMB-45, are critical to the correct dignosis. Pathological differentiation between primary and metastatic tumors is also important in making decisions about optimal management. The tumor behavior of mucosal melanoma is different from that of the cutaneous type. However, the prognosis of the former is rather poor. This paper reports on two patients with primary nasal mucosal melanoma who had nasal obstruction and epistaxis. Endoscopy revealed multiple black lesions which bled easily. Both patients had no local neck node or systemic metasasis, so they received wide excision of the tumor plus post-operative radiotherapy. One patient was well two years after surgery, but the other died of lung metastasis one years postoperatively. Conclusively, any drak-colored lesion in the nasal cavity must be carefully evaluated to disclose the hisopathological nature. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。