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HNO

, Volume 63, Issue 7, pp 523–536 | Cite as

Maligne Melanome im Kopf-Hals-Bereich

Teil 1: Diagnostik und histologische Besonderheiten
  • C. Pföhler
  • T. Vogt
  • C.S.L. MüllerEmail author
CME
  • 363 Downloads

Zusammenfassung

Etwa 15 % aller primär kutanen Melanome entstehen im Kopf-Hals-Bereich. Schleimhautmelanome sind sehr viel seltener und machen nur etwa 1 % aller Melanome aus, am häufigsten kommen diese jedoch im Bereich der Nase, der paranasalen Sinus und der Mundhöhle vor. Neben der klinischen Blickdiagnose kommt der Auflichtmikroskopie in der Bewertung melanomverdächtiger Läsionen eine große Bedeutung zu. Die feingewebliche Untersuchung des exzidierten Tumormaterials sichert die klinische Verdachtsdiagnose; diese bedarf besonderer Kenntnisse des Histopathologen und umfasst bei Vorliegen von Risikotumoren auch Untersuchungen im Hinblick auf im Tumor vorhandene Mutationen des NRAS-, BRAF- und KIT-Gens. Mit zunehmender Tumordicke und mit dem Vorhandensein weiterer prognostisch ungünstiger Faktoren wie Ulzeration des Primärtumors und Vorhandensein von Mitosen steigt das Risiko einer lymphatischen oder hämatogenen Metastasierung.

Schlüsselwörter

Häufigkeit Oropharynxtumoren Tumorinvasivität Morphologie Sentinellymphknotenbiopsie 

Malignant head and neck melanoma

Part 1: Diagnosis and histological particularities

Abstract

About 15 % of all cutaneous melanomas develop in the head and neck region. Mucosal melanomas are rare and represent only 1 % of all melanomas, however, most frequently, these are located in the nose, the paranasal sinuses and the oral cavity. Visual diagnosis and reflected-light microscopy are relevant for the evaluation of melanoma-suspect lesions. Histological investigation of resected tumors need special skills of the histopathologist and includes in case of high-risk tumors investigations of mutations in the tumor tissue concerning NRAS, BRAF and KIT. The risk of lymphatic or hematogeneous spread rises with increasing tumor thickness and the presence of further prognostic risk factors such as ulceration of the primary tumor or the presence of mitoses within the tumor.

Keywords

Incidence Oropharyngeal neoplasms Neoplasm invasiveness Morphology Sentinel lymph node biopsy 

Notes

Danksagung

Wir bedanken uns recht herzlich für die Überlassung von klinischem und histologischem Bildmaterial bei ao.Univ.-Prof. Dr.med.univ. Lorenzo Cerroni aus der Universitäts-Hautklinik in Graz, Österreich.

Einhaltung ethischer Richtlinien

Interessenkonflikt

C. Pföhler erhielt Referentenhonorare der Firmen Novartis, Stallergenes, Bencard Allergie, GlaxoSmithKline, AbbVie und HAL Allergie. C.S.L. Müller und T. Vogt geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  1. 1.Klinik für Dermatologie, Venerologie und AllergologieUniversitätsklinikum des SaarlandesHomburg/SaarDeutschland

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