9例鼻腔鼻窦原发黑色素瘤临床分析并文献复习

Clinical analysis and literature review of primary melanoma in nasal cavity and sinus——report of 9 cases

目的:对鼻腔鼻窦原发黑色素瘤的临床特征、治疗方案及生存率进行分析总结。方法:回顾性分析9例资料完整的鼻腔鼻窦原发黑色素瘤患者的临床特征、治疗方案及生存率并复习相关文献。结果:鼻腔鼻窦原发黑色素瘤的临床主要表现为患侧鼻腔进行性堵塞及间断性流鼻血。病理检查主要表现为肿瘤细胞异形性,胞质含有多量色素或不含色素,主要诊断依据为HMB45、S-100、melan-A部分或全部阳性。患者术后1年生存率为88.9%(8/9),3年为66.7%(6/9),5年为33.3%(3/9)。结论:鼻腔鼻窦原发黑色素瘤临床上发病率并不高,免疫组织化学即可以确诊,对病灶行广泛的根治性切除并辅助放疗可以提高患者生存率。

Objective：To analyze and summarize clinical characteristic,treatment scheme and survival rate of primary melanom in nasal cavity and sinus.Method：We retrospectively analyzed the 9patients with primary melanom in nasal cavity and sinus who in data proceed were treated and reviewed the related literature.Result：Among the 9patients,the clinical main symptoms are rhinostegnosis of lateral nasal and intermittent nasal bleeding.Pathologic examination is mainly characterized by tumor cells abnormity and cytoplasm containing pigment or without pigment,and main diagnosis basis is some or all of the positive for HMB45,S-100,melan-A.The survival rate are88.9%（8/9）of 1-year,66.7%（6/9）of 3-year and 33.3%（3/9）of 5-year.Conclusion：The incidence of primary melanom in nasal cavity and sinusis is not frequent in clinic and confirmed by immunohistochemical.The extensive radical excision of focus and combine adjuvant radiotherapy postoperative may improve the survival rate of patients.