原发性女性生殖系统恶性黑色素瘤临床病理特点

Clinicopathological characteristics of primary malignant melanoma of female genital tract

目的探讨原发性女性生殖系统恶性黑色素瘤的临床病理特点。方法收集2010年1月至2018年12月同济大学附属第一妇婴保健院收治的原发性女性生殖系统恶性黑色素瘤8例,对其临床和病理资料进行回顾性分析。结果8例患者中,原发于外阴、阴道、宫体和宫颈及卵巢的恶性黑色素瘤患者分别为2例(25%)、4例(50%)、1例(12.5%)、1例(12.5%)。除卵巢恶性黑色素瘤外,其余7例均先行肿瘤组织活检术,经病理及免疫组织化学染色确诊,免疫组化S-100和HMB-45均呈阳性表达,随后3例行肿瘤根治术。按照2009年FIGO分期Ⅰ期5例(62.5%),Ⅲ期1例(12.5%),Ⅳ期2例(25%)。8例患者中2例行免疫治疗,1例放化疗,1例化疗,1例中药治疗。8例患者中随访到5例,其中4例死亡,1例脑转移。结论原发性女性生殖系统恶性黑色素瘤比较少见,确诊时多为晚期,预后较差,应用免疫组化染色可协助鉴别诊断。

Objective To analyze the clinicopathological features of primary malignant melanoma of female genital tract.Methods The clinical and pathological materials of eight patients of primary malignant melanoma of female genitalia tract were retrospectively analyzed from January 2010 to December 2018 in our hospital.Results The tumors were originated from vulva,vagina,cervix and uterus and ovary in 2(25%),4(50%),1(12.5%),(12.5%).Except malignant melanoma of ovary,the other 7 cases were diagnosed by pathological and immunohistochemical staining.S-100 and HMB-45 were positive,and then 3 cases were treated by radical operation.According to the FIGO stage in 2009,there were 5 cases of stageⅠ(62.5%),1 case of stageⅢ(12.5%)and 2 cases of stageⅣ(25%).Of the 8 patients,2 received immunotherapy,1 received radiotherapy and chemotherapy,1 received chemotherapy,and 1 received traditional Chinese medicine.Of the 8 patients,5 were followed up,of which 4 died and 1 had brain metastasis.Conclusions Primary malignant melanoma of female reproductive system is relatively rare.Most of the cases were diagnosed at advanced stage and the prognosis was poor.Immunohistochemical staining can assist in differential diagnosis.