- 期刊
Primary Pulmonary Malignant Melanoma-A Case Report
原發性肺部惡性黑色瘤－病例報告
摘要
惡性黑色素瘤為皮膚惡性腫瘤中，惡性度高且最容易造成死亡的癌症之一，惡性黑色素瘤經常轉移至身體其他器官，肺部亦為常見轉移處。然而原發性肺部黑色素瘤病例極為罕見，診斷時需審慎排除肺部以外之可能原發部位。本個案為一78 歲男性，初始症狀為咳血與體重減輕，症狀持續約莫2 個月，胸部X 光顯示右側肺門腫塊，電腦斷層於右上肺葉前分支有一顯影良好腫瘤。最大徑為3.8 公分，氣管鏡檢查於RB3 發現咖啡色腫瘤，病患後續接受胸腔鏡右上肺葉切除暨淋巴結廓清術手術，病理染色確認為黑色素瘤，期別為pT2aN2M0，stage IIIA，病患至今術後追蹤1 年6 個月，未有復發及遠處轉移現象。
關鍵字
原發性肺部惡性黑色素瘤並列摘要
Malignant melanoma originates in melanocytes and is the leading cause of death among patients with skin cancer. Metastasis to other sites is common, but primary pulmonary malignant melanoma is extremely rare. Extra-pulmonary origin should be excluded by detailed examination to establish the diagnosis. Our patient, a 78-year-old male with a long-term history of asthma, presented with hemoptysis and weight loss of 5 kg in 2 months. Chest radiograph showed a round opacity, 4 cm in size, at the right hilum. Computed tomography of the chest revealed a lobulated mass, 3.8x2.6 cm, at the anterior segment of the right upper lobe. Bronchoscopy showed a brown, jelly-like mass obstructing the RB3 bronchus. Using VATS, right upper lobe lobectomy and radical lymph node dissection were performed. Histopathology confirmed malignant melanoma, and immunohistochemistry staining was positive for HMB45 and negative for CK and TTF-1. The pathological staging was pT2aN2M0, stage IIIA. There was no local recurrence or distant metastasis 18 months after surgery.