本文選題：巨型先天性黑色素痣 + 深部浸潤　； 參考：《中國修復重建外科雜志》2014年04期

【摘要】：目的總結1例腰背部巨型先天性黑色素痣(簡稱巨痣)的特點、治療方法及療效。方法 2013年7月收治1例13歲腰背部巨痣女性患兒,入院檢查示黑斑上至第12肋平面,下至臀部上份,兩側達腋前線;表面無毛發(fā),凹凸不平,顏色不均勻,質地偏硬。全麻下行腰背部巨痣切除聯(lián)合右側臀大肌肌瓣(12 cm×8 cm大小)、自體上背部網(wǎng)狀刃厚皮片(59 cm×47 cm大小)修復術,術中見巨痣浸潤深度達髂骨骨膜,浸潤寬度在真皮及以下,超出術前判定范圍。結果術后綜合病理檢查確診為巨痣,累及皮下組織,有壞死,部分細胞增生活躍。術后20 d創(chuàng)面愈合。術后6個月(2014年1月)隨訪,創(chuàng)面部分瘢痕形成,未見復發(fā)病灶。結論巨痣浸潤可深達骨膜,其皮下浸潤范圍可能超出肉眼所見;因有惡變風險,宜采取手術擴大切除。
[Abstract]:Objective to summarize the characteristics, treatment and curative effect of a case of giant congenital melanoma nevus on the back of the waist and back. Methods in July, 2013, a 13-year-old female patient with giant nevus of waist and back was admitted to our hospital. The examination showed that the black spot was above the 12th rib plane, the lower part was to the superior part of the hip, the two sides reached the front of axillary, the surface was hairless, uneven, uneven in color and hard in texture. Under general anesthesia, the resection of giant nevus of lumbar and back combined with the right gluteus maximus muscle flap was 12 cm 脳 8 cm in size, and the thickness of autogenous upper back reticular skin graft was 59 cm 脳 47 cm in size. It was found that the invasive depth of giant nevus reached to the iliac periosteum during the operation, and the width of the invasion was in the dermis and below. Beyond the range of preoperative judgment. Results the histopathological examination confirmed giant nevus, involving subcutaneous tissue, necrosis and active proliferation of some cells. The wound healed 20 days after operation. Six months after operation (January 2014), partial scar formation was found in the wound, and no recurrent lesions were found. Conclusion the invasion of giant nevus can reach the periosteum and the extent of subcutaneous infiltration may exceed that seen by the naked eye.
【作者單位】： 四川大學華西醫(yī)院燒傷整形科;
【分類號】：R758.51

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