黒色癌前駆症より発生した悪性黒色腫の1例

MALIGNANT MELANOMA DEVELOPED FROM MÉLANOSE CIRCONSCRIPTE PRÉCANCÉREUSE

I．緒言

　悪性黒色腫は色素性母斑，黒色癌前駆症および正常皮膚より発生するが^1），このなかで黒色癌前駆症から発展した悪性黒色腫の予後は比較的良好である^1）〜6）。しかし黒色癌前駆症がその好発部位である顔面と異つた部位に生じた場合は，悪性黒色腫の発生は急速で予後はかならずしも良好でない^7）。

　我々がここに報告する症例は56歳の女性で，初診時すでに外陰部に黒色癌前駆症より発生した悪性黒色腫と肺転移巣が認められ，その後急激な経過を辿り脳内転移により死亡した1例である。

While the prognosis of malignant melanoma developing from melanose circonscripte précan-céreuse is rather benign in general, that on the foot, axilla, genitalia, especially female genita-lia is grave.

A case of malignant melanoma on the ventral wall of the vagina in a 56-year-old woman was reported. She found a black macule on the right labia major 4 months ago. At her first visit a grayish black, irregularly colored and shaped, coin-sized fleck without infiltration surrounded by black papules was proved on the right labia major and minor. Furthermore, around the external orifice of urethra, a black, tip of thumb in size, dome-shaped, elastic hard tumor was found.

Histologic specimen from the fleck showed the picture of melanose circonscriptc précan-céreuse accompanied with segregation of atypical cells in some rete ridges. Those from the papules and the tumor were typical malignant melanoma.

It was diagnosed as a malignant melanoma developed from mélanose circonscripte précancéreuse, and disseminated metastasis in the lungs were found at the same time.

Combined dosage of three drugs-mitomycin, toyomycin, and dexamethasone-were performed, but the former two were obliged to interupt due to severe leucopenia and thromocytopenia.

While this therapy had no effect on the primary lesion, it showed some inhibitory effect on the development of metastasis in the lung.

General condition of the patient has been well maintained, but she died suddenly of metastasis of the brain.