Foley Claire K, Hughes Marybeth S, Hehman Charles T
Eastern Virginia Medical School, Norfolk, VA, USA.
Department of Surgery, Eastern Virginia Medical School, Norfolk, VA, USA.
J Surg Case Rep. 2023 Aug 14;2023(8):rjad469. doi: 10.1093/jscr/rjad469. eCollection 2023 Aug.
Melanoma is most associated with cancer of the skin. However, a small subset of these melanomas can be a primary malignancy of other mucosal membranes. A 55-year-old male presented to the gastroenterologist with 1 year of symptoms typical of colon cancer including bloating, abdominal pain and weight loss. He underwent colonoscopy and a mass was seen in the transverse colon that was later proven melanoma. A PET CT scan showed this was his only focus of disease. He then underwent a laparoscopic-assisted extended right hemicolectomy. He had an uneventful postoperative course. He was thoroughly examined for other sources of melanoma such as cutaneous, anal and uveal sources. He has recovered well at home and is receiving adjuvant pembrolizumab immunotherapy. Mucosal primary melanomas have a worse 5-year survival than primary cutaneous melanomas. A multi-disciplinary approach is necessary to treat and properly diagnose these malignancies.
黑色素瘤大多与皮肤癌相关。然而，这些黑色素瘤中有一小部分可能是其他黏膜的原发性恶性肿瘤。一名55岁男性因出现持续1年的典型结肠癌症状，如腹胀、腹痛和体重减轻，前往胃肠病专家处就诊。他接受了结肠镜检查，在横结肠发现一个肿块，后来被证实为黑色素瘤。正电子发射断层扫描计算机断层显像（PET CT）显示这是他唯一的病灶。随后，他接受了腹腔镜辅助扩大右半结肠切除术。术后恢复顺利。他还接受了全面检查，以寻找黑色素瘤的其他来源，如皮肤、肛门和葡萄膜来源。他在家中恢复良好，正在接受帕博利珠单抗辅助免疫治疗。黏膜原发性黑色素瘤的5年生存率低于原发性皮肤黑色素瘤。治疗和正确诊断这些恶性肿瘤需要多学科方法。
