[Pathomorphologic observation and prognostic analysis of 26 cases of malignant melanoma]

In this paper, 26 cases of malignant melanoma (MM) were analysed as to 10 items of clinicopathology, and 13 cases were followed. MM frequently occurs in the lower limbs. The peak age was 41 approximately 60 years. There was a history of having a black nevus (30.8%) and evident trauma (37.5%). Black nevus, located in the sole or palm, was able to undergo malignant change through long-term friction, irritation and so on. Therefore, preventive resection is necessary. Basing on the follow up study of 13 cases, three problems related to survival time are discussed: (1) Location of the tumor: MM in the mucosa has a worse prognosis than in the cutis. It might be considered as the rich blood supply to the mucosal tissue, easily resulting in hematogenous metastasis. (2) Clinical stage of the disease: The more advanced clinical stage, the shorter survival time. Early diagnosis and timely treatment play a key role in the prognosis. (3) TREATMENT: It is believed that extensive resection of the primary focus with dissection of the regional lymph nodes followed by adjuvant chemotherapy or Chinese traditional medicine is required. Correct diagnosis relies on the compositive analysis of 3 kinds of stain (iron reaction, fader and silver stain). The reticulum stain might be of benefit in differentiating the benign from malignant tumors. Diagnosis for the colorless MM depends on the finding of premelanin corpuscles by electronmicroscopy. In addition to Zhu Yuede's 9 criteria of diagnosis for MM, the authors propose that 4 features of MM in histostructure and cytomorphology be adhered to.