目的与方法:通过回顾一例泪小管泪总管交界处黏膜恶性黑色素瘤患者的临床资料和复习相关文献,探讨该病的临床表现、眼科专科检查、影像学特征及最新治疗动态。结果:泪道黏膜恶性黑色素瘤发病率低、恶性程度高、预后差,病理诊断是金标准,早期行正电子发射计算机断层显像(PET-CT)检查十分必要。结论:黏膜恶性黑色素瘤的治疗原则为尽量整块切除,禁忌局部挤压和力求切缘阴性,术后放疗可控制局部复发率。

[1] BATSAKIS J G,SUAREZ P.Mucosal melanomas:a review[J].Adv Anat Pathol,2000,7(3):167-180.
[2] SUBRAMANIAM S S,ANAND R,MELLOR T K,et al.Primary lacrimal sac melanoma with metastatic cervical disease:a review of the literature and case report[J].J Oral Maxillofac Surg,2017,75(7):1438-1441.
[3] KHANNA R K,FONTAINE A,LEMACON J M,et al.Hemolacria revealing a primary nasolacrimal duct melanoma[J].Can J Ophthalmol,2019,54(2):e70-e73.
[4] ESTEBAN F,GONZALEZ-PEREZ J M,BENAIXA J P,et al.Malignant melanomas of the nasolacrimal duct[J].J Laryngol Otol,2007,121(3):285-288.
[5] LEWIS A M,CLARKE P M,OLVER J M.Primary nasolacrimal duct malignant mucosal melanoma[J].Br J Ophthalmol,2006,90(1):114-115.
[6] LOPEZ F,RODRIGO J P,CARDESA A,et al.Update on primary head and neck mucosal melanoma[J].Head Neck,2016,38(1):147-155.
[7] JAKOBIEC F A,STAGNER A M,SUTULA F C,et al.Pigmentation of the lacrimal sac epithelium[J].Ophthalmic Plast Reconstr Surg,2016,32(6):415-423.
[8] 朱琰琰,斯璐,迟志宏,等.中国黑色素瘤患者BRAF基因突变分析[J].临床肿瘤学杂志,2009,14(7):585-588.
[9] 李丽,孔燕,李海夫,等.262例中国人黑色素瘤C-KIT基因扩增分析[J].临床肿瘤学杂志,2010,15(5):385-389.
[10] MATSUO T,TANAKA T,YAMASAKI O.Lacrimal sac malignant melanoma in 15 Japanese patients:case report and literature review[J].J Investig Med High Impact Case Rep,2019,7:1558614092.
[11] SHAO J W,YIN J H,XIANG S T,et al.CT and MRI findings in relapsing primary malignant melanoma of the lacrimal sac:a case report and brief literature review[J].BMC Ophthalmol,2020,20(1):191.
[12] LYDIATT W M,PATEL S G,O'SULLIVAN B,et al.Head and neck cancers-major changes in the American Joint Committee on cancer eighth edition cancer staging manual[J].CA Cancer J Clin,2017,67(2):122-137.
[13] 苏静,凌云.中国黑色素瘤规范化病理诊断专家共识(2017年版)[J].中华病理学杂志,2018,47(1):7-13.
[14] GLEIZAL A,KODJIKIAN L,LEBRETON F,et al.Early CT-scan for chronic lacrimal duct symptoms-case report of a malignant melanoma of the lacrimal sac and review of the literature[J].J Craniomaxillofac Surg,2005,33(3):201-204.
[15] KAVOUSSI S C,LEVIN F,SERVAT J J.Orbital extension of untreated lacrimal sac melanoma following dacryocystorhinostomy[J].Ophthalmic Plast Reconstr Surg,2016,32(3):e76.
[16] LORENZANO D,MISZKIEL K,ROSE G E.Orbital melanoma masquerading as a "galloping haemangioma"[J].Orbit,2017,36(2):81-83.
[17] 中国临床肿瘤学会指南工作委员会.中国临床肿瘤学会(CSCO)黑色素瘤诊疗指南2020[M].北京:人民卫生出版社,2020:95-107.
[18] LIAN B,SI L,CUI C,et al.Phase Ⅱ randomized trial comparing high-dose IFN-α2b with temozolomide plus cisplatin as systemic adjuvant therapy for resected mucosal melanoma[J].Clin Cancer Res,2013,19(16):4488-4498.
[19] CHRISTOPHERSON K,MALYAPA R S,WERNING J W,et al.Radiation therapy for mucosal melanoma of the head and neck[J].Am J Clin Oncol, 2015,38(1):87-89.
[20] MIZOE J E,HASEGAWA A,JINGU K,et al.Results of carbon ion radiotherapy for head and neck cancer[J].Radiother Oncol,2012,103(1):32-37.