An Unusual Initial Presentation of Hemothorax Due to Melanoma-A Case Report and Literature Review

以血胸爲初始表現之惡性黑色素細胞瘤－一病例報告及文獻回顧

曾筱倫(Hsaio-Lun Tseng) ； 林明憲(Ming-Shian Lin) ； 薛尊仁(Tzuen-Ren Hsiue) ； 鄭任勳(Jen-Hsun Cheng)

《胸腔醫學》 23卷6期 (2008/12) Pp. 435-440

https://doi.org/10.29806/TM.200812.0006

摘要

惡性黑色素細胞瘤容易有廣泛性全身性轉移之情形，而大約90%的病人表現有肺部轉移。少數病例以單純的惡性胸水、未合併肺部轉移來表現。我們提出一位以漸進性呼吸困難及單側量多之血胸來表現的病人，其肋膜切片報告顯示為惡性黑色素細胞瘤。此病人合併有大型先天性黑痣及外生殖器之乳房外柏哲德氏病(extramammary Paget's disease)，但其惡性黑色素細胞瘤之原發位置尚未證實。根據文獻報告，我們試著討論其為原發性肋膜黑色素細胞瘤之可能性，但現有之檢驗報告不足以診斷其原發處，仍需更進一步的影像學檢查、甚至病理檢驗。一旦病人被診斷有轉移性或再發性惡性黑色素細胞瘤，其預後通常不佳，病人的預期存活期將少於一年。

關鍵字

黑色素細胞瘤 ； 血胸 ； 大型先天性黑痣

並列摘要

Malignant melanoma has the potential for disseminated metastasis, and, almost 90% of patients have pulmonary metastasis. Rare cases have shown isolated malignant pleural effusion. We presented a patient who suffered from progressive dyspnea for more than 10 days, and unilateral massive hemothorax was found. Melanoma was diagnosed via closed pleural biopsy. The patient also had giant congenital melanocytic nevi and extra-mammary Paget's disease, but the primary origin of the melanoma was not identified. We explored the possibility of primary pleural melanoma in this patient by reviewing published articles. Further examinations were needed to establish the hypothesis. Once metastatic or recurrent melanoma is diagnosed, the prognosis is poor: life expectancy is lesser than 1 year.

並列關鍵字

melanoma ； hemothorax ； giant congenital melanocytic nevi