Меланома слизистых оболочек органов пищеварения

Меланома до 90% случаев поражает кожный покров и гораздо реже слизистые оболочки (2-3%). Меланомы слизистых оболочек органов головы и шеи составляют около 0,7-3,8 % от всех меланом и локализуются в околоносовых пазухах, полости рта, глотке, гортани. Они ассоциируются с очень неблагоприятным клиническим исходом и обладают высоким метастатическим потенциалом. Выбор тактики неоадъювантной и адъювантной лекарственной терапии остается открытым, в связи отсутствием достаточного количества исследований, подтверждающих их эффективность. Меланома также может возникать на слизистой оболочке практически любого отдела желудочно-кишечного тракта, также нередко рассматривается и как метастаз меланомы кожи или метастаз меланомы без выявленного первичного очага. При этом истинные первичные меланомы слизистых оболочек желудочно-кишечного тракта по частоте встречаемости располагаются следующим образом: анальный канал (31,4%), прямая кишка (22,2%), ротоглотка (32,8%), пищевод (5,9%), желудок (2,7%), тонкая кишка (2,3%) и ободочная кишка (0,9%). Факторы риска развития меланомы слизистых оболочек на сегодняшний день остаются неизвестными и не существует четких алгоритмов диагностики и лечения первичных меланом желудочно-кишечного тракта. В данной статье представлен обзор литературы по современным подходам к диагностике и лечению меланом слизистых оболочек.

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