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肛门直肠恶性黑色素瘤:乌尔法大学的经验。

Anorectal malignant melanomas: experience of Uludag University.

机构信息

Department of Surgical Pathology, Uludag University Medical School, Bursa, Turkey.

出版信息

Kaohsiung J Med Sci. 2010 Dec;26(12):658-62. doi: 10.1016/S1607-551X(10)70100-5.

Abstract

Anorectal melanomas represent a group of mucosal melanomas with unknown etiology and poor prognosis. The lesions can be misdiagnosed as hemorrhoids during clinical examination. We reviewed the morphological and clinical features of 14 anorectal melanomas, and discuss the treatment modalities of this entity. Fourteen patients who were diagnosed with anorectal malignant melanoma between 1997 and 2004 were evaluated with regard to age, sex, size, morphology, lymph node or distant metastasis, treatment modality and survival. Eight patients were female and six were male, and their mean age was 58 years. The size of melanoma ranged from 3 cm to 8 cm. Pathological evaluation revealed epithelioid and spindle cell type tumor in seven and two patients, respectively, whereas, in the remaining seven patients, the tumor was composed of both types. Pigmentation was apparent in all tumors. There was lymph node metastasis in 11 patients and distant metastasis in all patients. Eleven patients underwent abdominoperineal resection and three were treated by local excision. Mean survival was 8.7 months. Prognosis of anorectal melanoma remains poor. Awareness of the diverse clinicopathological features of these lesions, both on the part of the clinicians and pathologists, is crucial for their early detection and proper treatment.

摘要

肛门直肠黑色素瘤是一组病因不明、预后不良的黏膜黑色素瘤。在临床检查中,这些病变可能被误诊为痔疮。我们回顾了 14 例肛门直肠黑色素瘤的形态学和临床特征,并讨论了该疾病的治疗方式。

回顾性分析 1997 年至 2004 年间诊断为肛门直肠恶性黑色素瘤的 14 例患者的年龄、性别、大小、形态、淋巴结或远处转移、治疗方式和生存情况。8 例为女性,6 例为男性,平均年龄 58 岁。黑色素瘤大小从 3 厘米至 8 厘米不等。病理评估显示,7 例为上皮样细胞型肿瘤,2 例为梭形细胞型肿瘤,其余 7 例肿瘤由两种类型组成。所有肿瘤均有色素沉着。11 例患者有淋巴结转移,所有患者均有远处转移。11 例患者行腹会阴联合切除术,3 例患者行局部切除术。平均生存时间为 8.7 个月。肛门直肠黑色素瘤的预后仍然较差。临床医生和病理医生都必须意识到这些病变的不同临床病理特征,以便早期发现和适当治疗。

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