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患者男:56岁,工人,住院号41848,右胸壁恶性黑色素瘤伴右胸肋骨及口腔齿龈转移,化疗后完全缓解已近3年,较罕见。1985年5月发现右胸壁核桃大肿块,质中固定,伴该区皮肤疼痛,经右胸壁肿块穿刺涂片,细胞学诊断:找到恶性肿瘤细胞(倾向恶黑)。2个月后,原右胸壁肿块明显增大,为4×3×3cm。同年10月,相继发现左下颌齿龈处出现黑色核桃大肿块,生长十分迅速,已引起咀嚼及吞咽功能障碍。当时右陶壁肿块显著增大至10×10×5cm。伴同侧第5、6前肋骨质破坏;右肋隔角变钝。左下颌黑色肿瘤经活检;病理证实为恶性黑色素瘤。最后晚诊为右胸壁恶黑破坏肋骨并转移至口腔齿龈处。 治疗采用DO+CCNU(DO∶D为DTIC.O为VCR)
Male patient: 56 years old, worker, hospital number 41848, malignant melanoma of the right chest with right chest ribs and oral gingival metastases. Complete remission after chemotherapy has been nearly 3 years and is rare. In May 1985, a large lump of walnut in the right chest wall was found, fixed in the mass, accompanied by pain in the skin of the area, punctured by a right chest wall mass, and cytologically diagnosed: malignant cells were found (dark black). After 2 months, the original right chest wall mass increased significantly and was 4 x 3 x 3 cm. In October of the same year, large black walnut masses were found in the left mandibular gingivae, which grew rapidly and caused chewing and swallowing dysfunction. At the time, the right urethral mass was significantly increased to 10×10×5 cm. With ribs on the same side of the first 5,6 rib destruction; right rib angled blunt. The left lower jaw was diagnosed as a malignant melanoma by biopsy. The last late diagnosis was a black chest on the right chest wall that damaged the ribs and metastasized to the gums in the mouth. Treatment using DO+CCNU (DO: DTIC.O for VCR)