促纤维增生性恶性黑色素瘤8例临床病理分析

Clinicopathological analysis of patients with cutaneous desmoplastic melanoma

目的探讨促纤维增生性恶性黑色素瘤(DM)的临床病理特征及生物学行为。方法收集1996年至2004年间行广泛切除的8例DM患者,对其临床及病理资料进行分析。结果DM多位于头颈部,平均Breslow厚度为2.2 mm,所有病例未见淋巴结转移。平均随访43.2月,2例复发(1例全身转移),其中1例死亡,1例带瘤存活。结论DM具有独特的临床和病理特征,生物学行为惰性,长期随访表明其淋巴结转移率极低,病理上要与多种肉瘤及癌相鉴别,免疫组化染色有助于鉴别论断。

Objective To discuss the clinicopathological features of desmoplastic melanoma （DM）. Methods The data of eight patients with cutaneous DM underwent wide excision between 1996 and 2004 were analyzed retrospective. Results There were 5 male and 3 female patients. The median age was 64 years （range,35 -83 years）. The head and neck was the most commonly involved anatomical region. The median breslow thickness was 2.2 mm, No patient had a positive sentinel node. At a median follow -up of 43.2 months,two patients recurred （one systemic）, One of these patients died of disease, one was alive with disease. Conclusion DM is a biologically ditsinct form of melanoma ,with a very low incidence of regional lymph node metastases, either at presentation or in long - term follow - up. This biology should be considered when designing rational treatment strategies for these patients.