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Malignes Melanom des Viszerum (Primärtumor und Metastasen)

  • Chapter
Praxis der Viszeralchirurgie

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Zusammenfassung

Bei primären malignen Melanomen der Schleimhäute, insbesondere im Bereich der Nasenschleimhaut, der Vagina, des Anus und des Rektums wird eine vollständige Resektion des Melanoms angestrebt. Sehr ausgedehnte und mutilierende operative Eingriffe sind aber nicht indiziert, da bei Schleimhautmelanomen die Rezidivrate auch bei sehr radikalem Vorgehen hoch ist. Bei kutanen malignen Melanomen wird ab einer Tumordicke von 0,75–1 mm heute die Sentinellymphknotenbiopsie empfohlen, um bei Positivität eine elektive Lymphadenektomie vorzunehmen. Bei klinischem Lymphknotenbefall ist immer eine radikale Lymphadenektomie der Lympabflussregionen erforderlich. Bei Satelliten- oder Intransitmetastasen kommen in erster Linie chirurgische Resektionen, bei ausgedehntem Befall auch eine hypertherme Perfusionstherapie an den Extremitäten infrage. Bei viszeraler Metastasierung muss jeweils die Indikation für eine operative Therapie geprüft werden. Diese liegt dann vor, wenn bei singulärem Organbefall durch die operative Therapie die Möglichkeit zur vollständigen Metastasenresektion gegeben ist. Dieses ist insbesondere bei Vorhandensein weniger Metastasen an Lunge, Leber und Hirn der Fall.

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  1. C. Garbe
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  2. J. Göhl
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Editors and Affiliations

  1. Chirurgische Klinik und Poliklinik, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland

    J. R. Siewert

  2. Department für Chirurgie, Kantonsspital Basel, Spitalstraße 21, 4031, Basel, Schweiz

    F. Harder

  3. Klinik für Allgemeinchirurgie, Zentrum für Operative Medizin I, Baldingerstraße, 35043, Marburg, Deutschland

    M. Rothmund

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Garbe, C., Göhl, J. (2001). Malignes Melanom des Viszerum (Primärtumor und Metastasen). In: Siewert, J.R., Harder, F., Rothmund, M. (eds) Praxis der Viszeralchirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-09420-4_41

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