口腔粘膜原発悪性黒色腫の頚部転移巣にみられた desmoplastic malignant melanoma の1例

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Desmoplastic malignant melanoma (DMM) was a new clinicopathological entity as a variant of spindle cell malignant melanoma, which was first proposed by Conley et al in 1972. DMM shows features of a stony hard mass, proliferation of atypical spindle cells without distinct melanin pigments, and marked desmoplasia. The case was a 49 year old man. In 1986, the pigmented lesion of the upper gingiva and palate was diagnosed as lentigo malignant melanoma. He was treated by combination chemotherapy with DAV (DTIC, ACNU, VCR) and surgical excision. Pathological diagnosis of the lesion was malignant melanoma. In October 1987, metastasis arose in left cervical nodes and radical neck dissection was performed. However, In June 1990, a recurrence of the metastatic site occured. The tumor mass was 6.0×3.0×1.0 cm in size of a stony hard in consistency adhering to musculart issue. Excisional operative approach for the recurrent tumor was performed, but the tumor could not be excized because of adhesion to the left common carotid artery. Histopathological findings of the partially excisional tumor revealed marked proliferation of fibrous tissue containing a little atypical spindle shaped cells, without distinct melanin pigments. The tumor cells were slightly positive to Masson-Fontana staining. Immunohistopathologically, the tumor cells were positive to S-100 protein and neuron specific enolase staining. Histopathological diagnosis of the tumor was DMM. The patient has survived with the tumor without distant metastasis as of September 1991, but the tumor has grown little, under combination of chemotherapy and immunotherapy with intratumor injection of Interferon-β.
社団法人日本口腔外科学会の論文

口腔粘膜原発悪性黒色腫の頚部転移巣にみられた desmoplastic malignant melanoma の1例

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