喉腔及喉咽部原发性恶性黑色素瘤——4例报告并文献复习

Primary malignant melanoma of larynx and hypopharynx

喉腔及喉咽部原发性恶性黑色素瘤极为罕见。1985年～1997年8月,共收治喉腔、喉咽部粘膜原发性恶性黑色素瘤各2例,肿瘤多伴有溃疡并缺乏色素,临床表现为声音嘶哑、吞咽困难、咯血、咽部不适等,易与该部位常见的鳞状细胞癌相混淆。其中完整详实的病史、全面彻底的体格检查可提供重要的诊断依据,免疫组化病理有助确诊。大范围彻底的手术切除、根治性颈淋巴结清扫术可作为局限性原发病变的首选治疗。对术后可疑残留病变,可辅以放疗或化疗。

Primary malignant melanoma (MM) of larnx and hypopharynx is rare. From 1985 to August 1997) 2 cases of primary mucosal malignant melonoma origin in the larynx, hypopharynx were treated, respectively. Most of cases was combined with ulceration and lack of pigmentation. Clinical sympotoms were presented hoarseness of voice, dysphagia, hemoptysis, and abnormal sensation of throat. It is easily confused with more common types of squamous cell carcinomas of these sites. Complete history and physical examination may give the most important information. Immunohistochemistry can help to make the correct diagnosis. Large and complete surgical resection and radical neck dissection are treatment of choice for primary and regional lesions. Radiation and chemotherapy can privide palliative treatment of postoperative suspected residual lesion.