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目的:探讨鼻腔鼻窦恶性黑色素瘤的病理、临床特点及治疗方法。方法:鼻腔鼻窦恶性黑色素瘤24例中,鼻侧切开鼻腔鼻窦肿瘤切除术18例,颈外动脉结扎上颌骨大部分切除术2例,上颌窦根治术径路鼻腔鼻窦肿瘤切除术2例,颅面联合径路前颅底鼻腔鼻窦肿瘤切除术2例,同期行颈淋巴清扫术4例;单纯手术14例,手术加术后放疗8例,手术加放疗和化疗2例,其中1例加免疫治疗(IL2和IFN)。结果:24例患者中随访22例,失访2例,3年生存率为54.5%(12/22),5年生存率为31.8%(7/22)。结论:鼻腔鼻窦恶性黑色素瘤恶性程度高,易复发,早期诊断、根治性手术切除能提高本病生存率。
Objective: To investigate the pathology, clinical features and treatment of malignant melanoma of nasal sinuses. METHODS: Twenty-four patients with malignant melanoma of the nasal cavity and nasal sinuses underwent nasal resection of nasal cavity and nasal sinus tumor in 18 cases, maxillary external carotid artery ligation in 2 cases, maxillary sinus approach in 2 cases, craniofacial sinus surgery in 2 cases, 2 cases of anterior cranial base nasal sinus tumor resection and 4 cases of cervical lymph node dissection during the same period. There were 14 cases of simple operation, 8 cases of operation and postoperative radiotherapy, 2 cases of operation plus radiotherapy and chemotherapy, 1 case of immunotherapy (IL2 and IFN). Results: Of the 24 patients, 22 were followed up and 2 were lost. The 3-year survival rate was 54.5% (12/22) and the 5-year survival rate was 31.8% (7/22). Conclusion: Malignant melanoma of nasal sinus is highly malignant and easy to relapse. Early diagnosis and radical surgical resection can improve the survival rate of this disease.