文章：

妊娠期黑色素瘤——诊断、治疗及其对胎儿发育与妊娠维持的影响

Melanoma in Pregnancy—Diagnosis, Treatment, and Consequences for Fetal Development and the Maintenance of Pregnancy

原文发布日期：7 June 2024

DOI: 10.3390/cancers16122173

类型: Article

开放获取: 是

英文摘要：

Cutaneous malignant melanoma is one of the most common neoplasms among pregnancy-associated cancers (PACs). Risk factors include excessive exposure to ultraviolet radiation, the presence of benign and dysplastic nevi, and a patient or family history of melanoma. Self-examination and careful inspection of nevi are crucial, especially in the context of their progression over time. Physiological changes that occur during pregnancy, such as the darkening and enlargement of the nevi, delay the diagnosis of CMM. In the fetus, metastases are very rare, and if they do occur, they concern the placenta or fetal tissues. The choice of treatment is influenced by the cancer stage, symptoms, the time of termination of pregnancy, and the patient’s decision. Essential procedures which are safe for the fetus are diagnostic biopsy, ultrasound, and the therapeutic excision of the lesion and the affected lymph nodes. Other imaging methods can be used with a safe radiation dose limit of 100 mGy. Immunotherapy and targeted treatments must be carefully considered, because of their possible adverse effects on the fetus. An interdisciplinary approach to the problem of melanoma during pregnancy is necessary, involving doctors of various specialties.

摘要翻译： 

皮肤恶性黑色素瘤是妊娠相关癌症中最常见的肿瘤之一。其危险因素包括过度暴露于紫外线辐射、存在良性和发育不良痣，以及患者个人或家族黑色素瘤病史。自我检查和仔细观察痣的变化至关重要，尤其是在关注其随时间进展的情况下。妊娠期间发生的生理变化，如痣的颜色加深和体积增大，会延迟皮肤恶性黑色素瘤的诊断。胎儿发生转移的情况极为罕见，若发生则主要涉及胎盘或胎儿组织。治疗方案的选择受癌症分期、症状表现、终止妊娠时机及患者意愿的影响。对胎儿安全的必要操作包括诊断性活检、超声检查、病灶切除及受累淋巴结清扫。其他影像学检查可在安全辐射剂量限值100 mGy内使用。免疫疗法和靶向治疗因可能对胎儿产生不良影响，需审慎评估。妊娠期黑色素瘤的治疗需要采取多学科协作模式，汇集各专科医生共同参与。

原文链接：

Melanoma in Pregnancy—Diagnosis, Treatment, and Consequences for Fetal Development and the Maintenance of Pregnancy