DAV療法後に間質性肺炎ならびにDICにより死亡した malignant melanoma

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A61-year-old female had noticed a black macule on her left mandibular region about 7 years before, which gradually increased in size and partially elevated since about six months before. So she visited our clinic for the treatment of the black macule and nodule on June 2, 1993. Clinical diagnosis was lentigo maligna or lentigo maligna melanoma. Surgical resection was performed 1 cm apart from the margins of the lesion. Histologically, lentigious proliferation of atypical melanocyte was seen in the margins of the lesion. In the center of lesion, numerous tumor cell nests of atypical melanocytes were observed in the dermis, which had large, hyperchromatic, irregulary shaped nuclei. The diagnosis of the lesion was lentigo maligna melanoma. She received combination therapy, using IFN-β and chemotherapy (DAV). After wide resection and skin graft, she received combination therapy once more. In the end of August 1993, general malaise and dyspnea occurred. The laboratory examination showed DIC. ChestX-P and CT revealed interstitial pneumonitis (IP). Although the treatment for DIC and IP was carried out, she died on September 18, 1993, because her general condition rapidly deteriorated. From the findings mentioned above, we may suggest that the cause of her death was chemotherapeutic agent, probabry ACNU. We must pay further attention to the side effects of anti-cancer drugs.
日本皮膚悪性腫瘍学会の論文