Serra Marta, Santos Teresa, Martins Margarida, Sardo Leonor
Centro Hospitalar do Baixo Vouga - Av. Artur Ravara, 3810 - 501 Aveiro, Portugal.
Centro Hospitalar do Baixo Vouga - Av. Artur Ravara, 3810 - 501 Aveiro, Portugal.
Int J Surg Case Rep. 2019;55:164-167. doi: 10.1016/j.ijscr.2019.01.029. Epub 2019 Jan 31.
Anorectal malignant melanoma (AMM), is a rare and aggressive form of melanoma. Accounts for <2% of melanomas, and <2% of anal tumors. It is more frequent at the 6-7 decade, mostly in women. Surgery is the mainstay of treatment, but the extent is controversial.
82-year-old male, presented with rectal mass in the Emergency Room (ER). After local excision, pathology observed that the mass corresponded to AMM. Despite being stage I (Local disease), a year later it presented with local recurrence and distant metastasis. The patient died 32 months after diagnosis.
There is no optimal treatment, due to the lack of prospective studies. Wide local excision (WLE) has faster recovery, less post-operatory complications and similar survival rate compared to abdominal perineal resection (APR).
肛管直肠恶性黑色素瘤（AMM）是一种罕见且侵袭性强的黑色素瘤。占黑色素瘤的比例不到2%，占肛门肿瘤的比例也不到2%。多见于60至70岁人群，女性更为常见。手术是主要的治疗方法，但手术范围存在争议。
一名82岁男性因直肠肿物就诊于急诊室。局部切除术后，病理检查发现肿物为肛管直肠恶性黑色素瘤。尽管处于I期（局部病变），但一年后出现局部复发和远处转移。患者在诊断后32个月死亡。
由于缺乏前瞻性研究，尚无最佳治疗方案。与腹会阴联合切除术（APR）相比，广泛局部切除术（WLE）恢复更快，术后并发症更少，生存率相似。
