原发性女性尿道黑色素瘤(附4例报告)

Primary melanoma of the female urethra (Report of 4 cases)

目的 探讨女性尿道原发性恶性黑色素瘤的临床特征及治疗方法。方法 对4例女性原发性恶性黑色素瘤进行临床病理分析及随访观察。结果 4例患者均为尿道外口肿物就诊。2例因术前诊断不清,仅作局部切除,其中 1 例术后 16 个月死于肿瘤复发,1例仍在随访中;另2例行全尿道切除,双侧腹股沟淋巴结清扫及永久性膀胱造瘘。结论 女性尿道原发性黑色素瘤恶性度高,临床易误诊,早期诊断的主要依据是病理学探查,及时规范手术是提高患者生存率的主要方法。

Objective To study the clinical features and treatment of primary melanoma of the female urethra. Methods Four cases of primary melanoma of the female urethra were investigated by clinicopathological analysis and followed up. Results Four cases of elder female patients presented gradually enlarging urethral masses. Two were misdiagnozed as urethral caruncle. One patient died of the recurrence of the disease 16 months after initial diagnosis and local resection. Total urethretomy and bilateral inguinal lymph node dissection and cystostomy were performed in two cases. Conclusion Primary melanoma of the female urethra is highly malignant and easily misdiagnosed as other diseases. Pathological examination is the most important method for early diagnosis. Timely and proper operations should be carried out to improve the patient's quality of life.