Yokota Kentaro, Takahashi Masahiro, Okada Kuniaki, Ishizu Hiroyuki, Masuko Hiroyuki, Tanaka Koichi, Hata Tsunetake, Kawamura Hideki, Yamagami Hideki, Watarai Hiroshi, Tanioka Toshiro
Dept. of Surgery, Hokkaido P.S.F.A.C Sapporo Kosei Hospital.
Gan To Kagaku Ryoho. 2011 Nov;38(12):2045-7.
Malignant melanoma of the anorectal region is rare, and the prognosis is considered to be poor. We present a case of long-term survival in a 56-year-old patient with primary malignant melanoma in the anorectal area, who complained of anal bleeding. Barium enema showed an elevated lesion in the anorectal region. Colonoscopy revealed a 3 cm sessile tumor with focal pigmentation, and a satellite nodule, 1 cm in diameter. Based on diagnosis of malignant melanoma by biopsy, abdominoperineal resection with lateral node dissection was performed. Pathologically the tumor remained in the mucosa, and no lymph node metastasis was found. This patient refused any adjuvant chemotherapy after the operation, and remains well without any sign of recurrence for seven years.
肛管直肠区域的恶性黑色素瘤很罕见,且预后被认为较差。我们报告一例56岁原发性肛管直肠恶性黑色素瘤患者长期存活的病例,该患者主诉肛门出血。钡剂灌肠显示肛管直肠区域有一隆起性病变。结肠镜检查发现一个3厘米的无蒂肿瘤,伴有局灶性色素沉着,还有一个直径1厘米的卫星结节。经活检诊断为恶性黑色素瘤后,行腹会阴联合切除术及侧方淋巴结清扫术。病理检查显示肿瘤仍局限于黏膜层,未发现淋巴结转移。该患者术后拒绝任何辅助化疗,至今七年情况良好,无任何复发迹象。