Malik Ahsan, Bansil Sandeep, Junglee Naushad, Sutton Jonathon, Gasem Jaber, Ahmed Waqar
Department of Gastroenterology, Ysbyty Gwynedd, Bangor, UK.
BMJ Case Rep. 2011 Jul 28;2011:bcr0320114034. doi: 10.1136/bcr.03.2011.4034.
The authors present a case of a gentleman in his 70s who was referred to the gastroenterology outpatient clinic with dysphagia. An oesophagogastroduodenoscopy was performed which showed a polypoidal black coloured mass in the oesophagus. Endoscopic biopsies confirmed malignant melanoma. Further staging investigations were organised to assess suitability for surgery which revealed a mass in the sigmoid colon. Subsequent colonoscopy and biopsy confirmed adenocarcinoma. As this was an unusual case to associate these two malignancies at the same time, there was no ideal or recognised management plan available. Different treatment options were considered and a consensus was developed regarding best surgical approach but due to the lapse in time a repeat staging CT scan was organised which unfortunately now demonstrated lymph node metastasis. Patient was managed conservatively from this point onwards and he died 12 months later.
作者报告了一例70多岁男性患者，因吞咽困难被转诊至胃肠病门诊。进行了食管胃十二指肠镜检查，结果显示食管内有一个息肉样黑色肿物。内镜活检确诊为恶性黑色素瘤。为评估手术的适用性，进一步安排了分期检查，结果显示乙状结肠有肿物。随后的结肠镜检查和活检确诊为腺癌。由于同时出现这两种恶性肿瘤的情况不常见，当时没有理想的或公认的管理方案。考虑了不同的治疗方案，并就最佳手术方法达成了共识，但由于时间延误，安排了重复的分期CT扫描，不幸的是此时已显示有淋巴结转移。从这时起，对患者进行了保守治疗，12个月后患者死亡。
