Su Meng, Zhu Lucheng, Luo Wenhua, Wei Hangping, Zou Changlin
Department of Radio-Chemotherapy Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China.
Oncol Lett. 2014 May;7(5):1605-1607. doi: 10.3892/ol.2014.1925. Epub 2014 Feb 28.
Primary anorectal (PA) malignant melanoma (MM) is a rare disease associated with a high mortality rate. The most appropriate treatment strategy for PAMM remains controversial. A 55-year-old female patient, who was misdiagnosed with locally advanced rectal carcinoma, was treated with preoperative radiotherapy and concurrent oral capecitabine. During the therapy, grade 1 leukopenia occurred, however, there was no interruption to treatment. Following chemoradiotherapy, a computer tomography scan identified that the tumor had shrunk significantly and the original enlarged lymph nodes had disappeared. Eight weeks after completion of chemoradiotherapy, sphincter-sparing surgery was performed on the patient and based on the postoperative pathological result, MM was diagnosed. At the time of writing, the patient has survived disease-free for 15 months and at the most recent follow-up examination the Karnofsky Performance Scale score was 100. The therapeutic regimen of neoadjuvant concurrent chemoradiotherapy together with sphincter-sparing surgery is considered to be an optimal choice for patients with PAMM. However, further studies are required to evaluate the efficacy and clinical utility of this therapeutic regimen.
原发性肛管（PA）恶性黑色素瘤（MM）是一种罕见疾病，死亡率很高。原发性肛管恶性黑色素瘤最合适的治疗策略仍存在争议。一名55岁女性患者，最初被误诊为局部晚期直肠癌，接受了术前放疗及口服卡培他滨同步治疗。治疗期间出现1级白细胞减少，但治疗未中断。放化疗后，计算机断层扫描显示肿瘤显著缩小，原来肿大的淋巴结消失。放化疗结束8周后，对该患者实施了保留括约肌手术，术后病理结果确诊为恶性黑色素瘤。撰写本文时，该患者已无病生存15个月，最近一次随访检查时卡氏功能状态评分（Karnofsky Performance Scale）为100分。新辅助同步放化疗联合保留括约肌手术的治疗方案被认为是原发性肛管恶性黑色素瘤患者的最佳选择。然而，需要进一步研究来评估该治疗方案的疗效和临床实用性。
