A Retrospective Analysis Of78Cases Primary Cutaneous Malignant Melanoma In Clinical And Pathological Features

Objective: To improve the diagnosis and treatment of primary cutaneousmalignant melanoma(CMM) by retrospectively analyzing the clinical and pathologicalfeatures and diagnostic methods78patients with CMM.Methods: From January2000to January2014, pathology and clinicalfollow-updata of the78patients with CMM in the dermatology department of TheGeneral Military Hospital of Shenyang Region were reviewed,and the clinical features,pathogenesis,diagnostic and therapeutic methods, patients’ survival and tumorrecurrence were analyzed retrospectively.Results: There were35female and43male patients with a average age of56.5years old.During78CMM cases,59cases located on the acral sites,3on arms,2onlegs,2on faces,2on scalp,1on the neck and9cases on the trunks.Fusiformcell,epithelioid cell or both of them could be observed under the microscope.20caseswere carcinoma in situ(25.64%),and the pTNM stage from stage Ⅰ toⅣ involed13cases(16.67%),30cases(38.46%),11cases(14.10%) and4cases(5.13%).As of January2013,19patients were withdrawn after12months’ follow-up.The follow-up resultsshowed that: none of the patients in the early stage of the CMM(0～Ⅰstage) die fromthis disease or recurred or metastasized.Of the23cases of stage Ⅱ,six patients diedfrom this disease,and of the six patients who took the regular reexamninations,two cases had local regional recurrence while one case had a distant metastasis.Of the10cases ofstage Ⅲ,eight patients died from recurrence or metastasis of CMM(five cases diedwithin36months,two cases died during36months to60months while one case diedafter60months),two paitents who took the regular follow-up showed no evidence ofrecurrence or metastasis. All of the4stage Ⅳ patients died from CMM within a year.Conclusion:1. Malignant melanoma is a most aggressive tumor and acrallentiginous melanoma is the main type of CMM in China.The incidence of CMM isgenerally associated with inflammation and UV damage,which emphysize the importantrole the health education and cancer prevention made in the early diagnosis andtreatment.2.The final diagnosis of CMM depends on pathological examination andimmunohistochemical results．The depth of tumor invasion, ulcers and TNM stage arethe factors that affected the prognosis of CMM.3.Surgery remains the main treatment in patients with CMM,and complete excisionshould be focused on during the operation.The selcetion of the esection range andresonable adjutant therapy should be choose according to pathological staging. With thedevelopment of biotechnology, new targeted drugs and immune therapy of researchshow a good prospect of clinical application in improving the clinical survival rate andthe prognosis of CMM.