原發性口腔黏膜黑色素瘤：病例報告

90%以上的黑色素瘤發生在皮膚上，好發的部位則位於四肢及軀幹部。而黏膜黑色素瘤是一種罕見而預後非常差的惡性腫瘤，約佔所有黑色素瘤不到2%，發生的部位可見於生殖泌尿道、肛門直腸、口鼻咽部等等。頭頸部黏膜黑色素瘤好發於60至80歲年齡層，日本人及黑人有較高的發生率，上頷齒齦及硬腭處為最常好發的部位。一般黑色素瘤外觀表現為有色斑的腫塊，症狀通常則是呈現無痛現象，其他，如外觀表面潰瘍、流血疼痛感症狀等也經常會出現於臨床上。口腔內的黑色素瘤只有三分之一會出現典型色素沈積現象，因此在臨床診斷更形困難，故適時懷疑及進行病理組織切片檢查是建立早期診斷之關鍵。目前治療方式仍以手術切除為主，或是合併放射治療、化學治療、免疫療法等。本文提出一例罹患上頷齒齦黑色素瘤的患者，就其發病過程、臨床檢查、手術及治療方式和追蹤情形作一完整之報告。

關鍵字

黏膜黑色素瘤；診斷；手術切除

並列摘要

Above 90% of melanomas arise from skin. The most common sites are trunk and extremities. Mucosal melanoma is relatively rare and less than 2% of all melanomas. Mucosal melanoma can be found in the urinary tract, vagina, colon, pharynx, larynx, oral cavity and the nasal cavity. The mucosal melanoma of head and neck occurred in patients between age 60 and 80. The high incidence occurred in Japanese, Black. Oral melanoma mostly occurred in the upper gingival and the palate. The oral symptoms were usually painless, bleeding and ulceration clinically. One third of the lesion was pigmented. It makes diagnosis become more difficult in initially clinically. The key of early diagnosis is to make the suspicion timely and undergo pathologic biopsy. Surgical excision was mode for the major therapy, or combined with radiotherapy, chemotherapy and immunotherapy. We reveal a case of malignant melanoma of upper gingival and report present illness, clinical exam, surgical therapy, treatment and post-operation follow up in particulars.

並列關鍵字

Mucosal melanoma ； Diagnosis ； Surgical excision

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原發性口腔黏膜黑色素瘤：病例報告

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