恶性阴道黑色素细胞瘤

惡性陰道黑色素細胞瘤 Primary Malignant Vaginal Melanoma 胡偉敏;莊其穆;趙灌中;王鵬惠 婦產學科 期刊名稱(journal): 中華民國婦癌醫學雜誌 卷(vol.): 期(issue.): Issue. 2 年代(year.): 2006 摘要: 惡性陰道黑色素細胞是一種非常少見的婦科癌症，因為病例極少及其預後也不佳，在此簡單 的介紹此一罕見的疾病。 Abstract: Primary malignant melanoma of the vagina is a very rare gynecologic malignancy and limited data are available on which to base recommendations for the primary management of patients. The tumor is primarily found in the distal one-third (58%) of the vagina and mostly on the anterior wall (45%). A low occurrence of this type of tumor makes the assessment of various treatment options difficult. There are several treatment options but none of them is proved to be standard approach. As treatment options, there are some standard modalities used individually or in combination, such as conservative wide local excision, radical surgical extirpation, irradiation and chemotherapy. The spectrum of surgical therapy ranges from conservative surgery such as wide excision of the lesion or total vaginectomy to radical extirpation with en bloc removal of involved pelvic organs. Regardless of the extent of primary surgery, positive histological margins or presence of melanoma in situ at the edge of the specimen result in a higher incidence of recurrence and poorer survival rates. The role of elective lymph node dissection remains controversial. The dissection of lymph nodes that are clinically negative for melanoma of the vagina is debatable. The indication of evaluation of pelvic nodes is also debatable.