鼻腔原发性恶性黑色素瘤25例临床病理分析

Morphological Research of Primary Nasal Malignant Melanoma: Report of 25 Cases

目的观察鼻腔原发性恶性黑色素瘤的形态特点，以帮助临床诊断和治疗。方法对1975年-2006年间诊治的鼻腔原发性恶性黑色素瘤25例的临床资料进行回顾性分析。结果25例中，肿瘤多位于鼻腔外侧壁和鼻中隔，中鼻道10例，鼻中隔6例，中鼻甲4例，下鼻甲3例，鼻底1例，另1例病变范围广无法判断其来源。肿瘤呈黑色或紫褐色21例，呈结节状或菜花状；淡红色表面光滑如息肉状4例；肿瘤触之易出血。结论鼻腔原发性恶性黑色素瘤临床少见，易误诊，应与鼻腔癌、血管瘤、鼻息肉相鉴别；对鼻腔发现的黑色或紫褐色肿物，触之易出血者可作该病的临床诊断，活检应谨慎，以免促进肿瘤转移。

Objective The moaphological characters of primary nasal malignant melanoma were studied, these were helpful to clinical diagnosis and treatment, Methods This article reviewed the clinical data of 25 cases of primary nasal malignant melanoma from 1975 to June 2006. Results Of the 25 cases,it was thought that the tumor arised mainly from the lateral wall of nasal cavity and nasal septum ,there were 21 black or black - brown masses with tubercular or cauliflower - like and 4 light red colour masses with polypoid of intact mucosa,it＇s hemorrhagic easily while touching it. Conclusion The primary nasal malignant melanoma is rare disease likely to be misdiagnosed,it must be essential to make differential diagnosis with the carcinoma of nasal cavity and anginoma as well as nasal polyp, If a black or black mass is examined in nasal cavity and it＇s hemorrhagic easily while touching it,you can make a clinical diagnosis of primary nasal malignant melanoma. In order to avoid metastasis of the tumor, the biopsy is not advised.