Malignant melanoma: the patient with an unknown site of primary origin.
Malignant melanoma: the patient with an unknown site of primary origin.
复制标题
恶性黑色素瘤：原发部位不明的患者。
作者：
G. Baab;C. McBride
在2,446例恶性黑色素瘤患者中，有4%的患者没有已知的原发部位。超过一半的患者仅因淋巴结疾病入院，并接受了区域淋巴结清扫术。该组中有33%的人在治疗后存活了5年，22%的人在治疗后存活了10年。三分之一的人因内脏转移而入院，其中许多人适合手术，这组人的五年生存率为5%。皮肤播散具有致命的预后。治疗后复发倾向于与原始转移相同的身体区域，其中50%的复发发生在治疗后6个月内。这些原发肿瘤不明的患者的性别比、年龄发病率、家族史和生存率与转移性疾病的起源部位为未被注意到的皮肤病变一致。我们必须假定，这一病变已经自然消退。
Four percent of 2,446 patients with malignant melanoma did not have a known site of primary origin. More than half were admitted with nodal disease only, and were treated with regional node dissections. Thirty-three percent of this group lived five years, and 22 percent lived ten years following treatment. One third were admitted with visceral metastases, many of which were amenable to surgery, and this group experienced a 5 percent five-year survival rate. Cutaneous dissemination carried a lethal prognosis. Recurrences following treatment tended toward the same region of the body as the original metastasis, and 50 percent of these recurrences occurred within six months of therapy. The sex ratio, age incidence, family history, and survival rates in these patients with unknown primary tumors are consistent with an unnoticed cutaneous lesion as the site of origin for the metastatic disease. It must be supposed that this lesion had undergone spontaneous regression.