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今天與許多台灣醫師一起在辦於珠海的中華醫學會年會演講。我跟皮膚病理泰斗吳育弘醫師一起演講「困難黑色素瘤的早期診斷與治療」
我們想讓大家知道的重點：
1. 早期的甲下黑色素瘤（subungual melanoma)病理診斷可能非常困難，可能只有很少量的間斷的不正常黑色素細胞，有賴非常有經驗的皮膚病理醫師診斷 否則可能誤診成良性。
2. 腳底黑色素瘤範圍可能比肉眼及皮鏡可看到的大的多，照現行AJCC8th guideline切除範圍可能還不夠。慢莫氏手術可幫助確認腫瘤是否有切除乾淨。
例如黑色素癌原位癌（melanoma in situ)現行準則切除範圍為0.5公分，但我們發現有些原位癌病人經慢莫氏手術確認範圍 最後需要切除到2.5公分才足夠。
3. 腳底黑色素瘤手術方式已有皮瓣手術以外的選擇，適當配合傷口負壓治療，可減少傷口疼痛, 減少住院天數及細菌感染，病人最後可恢復術前腳部功能，復發率與傳統手術相當，且疤痕美觀。
#黑色素瘤
#皮膚病理
#AJCC 8th
AJCC Melanoma of the Skin Staging (8th Edition). 8771 views on Imgur: The magic of the Internet. More like this. Health Promotion Board, Stage 4 Colon ... ... <看更多>
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