外阴阴道恶性黑色素瘤20例临床分析

Clinical analysis of 20 cases of malignant melanoma of vulva and vagina

目的:研究原发女性外阴阴道恶性黑色素瘤的临床特点、治疗和预后。方法:系统回顾本院自1976年6月-2006年3月收治的20例原发性女性外阴阴道恶性黑色素瘤的临床资料。结果:本组病例平均年龄48.5岁,绝经后妇女占55%。20例病例中手术治疗19例,1例仅行腹壁下动脉化疗。术后发现8例外阴恶性黑色素瘤患者腹股沟淋巴结转移2例,12例阴道恶性黑色素瘤中,腹股沟淋巴结转移2例,盆腔淋巴结转移2例。外阴恶性黑色素瘤的5年生存率为25%,平均生存期为40.7个月,阴道恶性黑色素瘤的5年生存率为16.7%,平均生存期为19.7个月。结论:女性外阴阴道恶性黑色素瘤是一类恶性程度高,预后差的肿瘤,手术是治疗的主要手段,临床分期,肿瘤部位,病灶大小,淋巴结转移及治疗方法是影响预后的因素;局部复发和早期转移是预后差的主要原因。

Objective ：To investigate the clinical characteristics and treatment , prognosis in patients with the primary malignant melanoma of vulva and vagina. Methods： The clinical data of 20 patients with primary malignant melanoma of the vulva and vagina admitted to our hospital from June 1976 to March 2006 were analysed retrospectively. Results： The mean age of the patients was 48.5 years,55% of them was post -menopause women, 19 of the 20 patients were treated with surgery, and one case only chemotherapy through arteria epigastria inferior. After the operation,2 of the 8 patients with primary malignant melanoma of the vulva were found having inguinal lymph nodes in volvement, 2 of the 12 patients with primary malignant melanoma of the vagina were found having inguinal lymph nodes in volvement and 2 having pelvic lymph nodes in volvement. The 5 - year survival rate of vulva malignant melanoma was 25% ,and mean survival time was 40.7 months. The 5 -year survival rate of vagina malignant melanoma was 16.7% ,and mean survival time was 19.7 months. Conclusion： The malignant melanoma of female vulva and vagina is an high malignancy tumor and its prognosis is poor, main therapy is operation. Its prognosis is influenced byclinical stage, tumor site, tumor size, lymph nodes involvement and therapy. The main causes of its poor prognosis are local recurrence and early metastasis.