Balicevic Drinko, Tomic Karla, Bekavac-Beslin Miroslav, Kovacevic Igor, Mijic August, Belicza Mladen, Kruslin Bozo
Ljudevit Jurak Department of Pathology, University Hospital Sestre Milosrdnice, Zagreb, Croatia.
World J Gastroenterol. 2006 Jun 7;12(21):3453-5. doi: 10.3748/wjg.v12.i21.3453.
Anorectal melanoma is a very rare tumor with poor prognosis. Rectal bleeding is the most frequent symptom and surgical treatment ranges from local excision to radical abdominoperineal resection. We report a case of a 75-years-old male patient who presented with a history of recurrent rectal bleeding, and whose histopathological diagnosis was melanoma. Macroscopically, we found two distinct tumors in anorectal region, 0.5 cm and 1.5 cm from dentate line. The first one was pedunculated, on a thin stalk, measuring 1 cm in greatest diameter, and the second one was sessile and nodular measuring up to 2.8 cm in largest diameter. Microscopic examination and immunohistochemical analysis of both tumors confirmed the diagnosis of melanoma. This case represents multiple synchronous primary melanoma of the anorectal region, with a possibility that one of the lesions is primary melanoma and the second one is a satellite lesion.
肛管直肠黑色素瘤是一种非常罕见且预后较差的肿瘤。直肠出血是最常见的症状，手术治疗范围从局部切除到根治性腹会阴联合切除术。我们报告一例75岁男性患者，有反复直肠出血病史，其组织病理学诊断为黑色素瘤。肉眼可见，在肛管直肠区域发现两个不同的肿瘤，距齿状线分别为0.5厘米和1.5厘米。第一个肿瘤有蒂，蒂细，最大直径为1厘米，第二个肿瘤无蒂且呈结节状，最大直径达2.8厘米。对这两个肿瘤进行显微镜检查和免疫组化分析均确诊为黑色素瘤。该病例代表肛管直肠区域的多发同步原发性黑色素瘤，其中一个病灶有可能是原发性黑色素瘤，另一个是卫星病灶。
