目的 总结1例腰背部巨型先天性黑色素痣（简称巨痣）的特点、治疗方法及疗效。
方法 2013年7月收治1例13岁腰背部巨痣女性患儿，入院检查示黑斑上至第12肋平面，下至臀部上份，两侧达腋前线；表面无毛发，凹凸不平，颜色不均匀，质地偏硬。全麻下行腰背部巨痣切除联合右侧臀大肌肌瓣（12 cm×8 cm大小）、自体上背部网状刃厚皮片（59 cm×47 cm大小）修复术，术中见巨痣浸润深度达髂骨骨膜，浸润宽度在真皮及以下，超出术前判定范围。
结果 术后综合病理检查确诊为巨痣，累及皮下组织，有坏死，部分细胞增生活跃。术后20 d创面愈合。术后6个月（2014年1月）随访，创面部分瘢痕形成，未见复发病灶。
结论 巨痣浸润可深达骨膜，其皮下浸润范围可能超出肉眼所见；因有恶变风险，宜采取手术扩大切除。
Citation：
刘洪均, 岑瑛, 刘晓雪. 腰背部巨型先天性黑色素痣一例报告. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(4): 527-528. doi: 10.7507/1002-1892.20140118
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Copyright © the editorial department of Chinese Journal of Reparative and Reconstructive Surgery of West China Medical Publisher. All rights reserved
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- 1. Das SK, Amarendra M, Subudhi M. Giant congenital melanocytic nevi:a case report. J Clin Diagn Res, 2013, 7(1):154-155.
- 2. Quaba AA, Waace AF. The incidence of malignant melanoma (0 to 15 years of age) arising in "large" congenital nevocellular nevi. Plast Reconstr Surg, 1986, 78(2):174-181.
- 3. Arneja JS, Gosain AK. Giant congenital melanocytic nevi of the trunk and an algorithm for treatment. J Craniofac Surg, 2005, 16(5):886-893.
- 4. Al-Hadithy N, Al-Nakib K, McGurk S, et al. Primary intracranial melanoma in a child with a giant congenital melanocytic naevus and normal MRI. BMJ Case Rep, 2013.[Epub ahead of print].
- 5. Lovett A, Maari C, Decarie JC, et al. Large congenital melanocytic nevi and neurocutaneous melanocytosis:one pediatric center's experience. J Am Acad Dermatol, 2009, 61(5):766-774.
- 6. Vourc'h-Jourdain M, Martin L, Barbarot S, et al. Large congenital melanocytic nevi:therapeutic management and melanoma risk:a systematic review. J Am Acad Dermatol, 2013, 68(3):493-498. e1-14.
- 7. Marghoob AA, Agero AL, Benvenuto-Andrade C, et al. Large congenital melanocytic nevi, risk of cutaneous melanoma, and prophylactic surgery. J Am Acad Dermatol, 2006, 54(5):868-870.
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