Kusminsky R E, Bailey W
Dis Colon Rectum. 1977 Oct;20(7):580-99. doi: 10.1007/BF02586622.
Since 1872, 168 rectal leiomyomas have been reported in the world literature. Their incidence, therefore, is very low. It is estimated that one leiomyoma may be seen for every 2,000 or more rectal tumors. Those leiomyomas located in the anal canal and sphincter are the rarest. A case is reported here that appears to be the eleventh in such a location. The incidence of these lesions is highest between the ages of 40 and 59 years. Most patients have a combination of symptoms rather than a single one, the most frequent of these being the presence of a mass, bleeding, and constipation. Almost always, the chain of events that leads to the diagnosis starts when the tumor is discovered by digital examination of the rectum. The lack of reliable criteria of malignancy and the marked tendency to recur shown by these tumors are the two main problems the surgeon faces when selecting the operative procedure to be used. We believe that those tumors with an original size of 5 cm or more in largest diameter are the ones that have shown the highest tendency to recur, mostly as sarcomas. Therefore it is thought that these lesions should be treated radically from the beginning, especially when they recur. More adequate follow-up studies are needed.
自1872年以来，世界文献中已报道了168例直肠平滑肌瘤。因此，其发病率非常低。据估计，每2000例或更多的直肠肿瘤中可能会出现1例平滑肌瘤。位于肛管和括约肌的平滑肌瘤最为罕见。本文报告了1例，这似乎是该部位的第11例。这些病变的发病率在40至59岁之间最高。大多数患者有多种症状，而非单一症状，其中最常见的是肿块、出血和便秘。几乎总是这样，导致诊断的一系列事件始于直肠指检发现肿瘤。这些肿瘤缺乏可靠的恶性标准以及明显的复发倾向，是外科医生在选择手术方式时面临的两个主要问题。我们认为，最大直径原始尺寸为5厘米或更大的肿瘤复发倾向最高，大多复发为肉瘤。因此，人们认为这些病变应从一开始就进行根治性治疗，尤其是在复发时。需要进行更充分的随访研究。
