Xiong Zhang-E, Wei Xin-Xiang, Wang Li, Xia Chen, Li Zi-Yin, Long Chan, Peng Bo, Wang Ting
Department of Gastroenterology, Wuhan Third Hospital, Wuhan 430060, Hubei Province, China.
Department of Pharmacy, Wuhan University of Science and Technology, Wuhan 430065, Hubei Province, China.
World J Clin Cases. 2024 Jun 6;12(16):2862-2868. doi: 10.12998/wjcc.v12.i16.2862.
Rectal mucosal melanoma is a rare and highly aggressive disease. Common symptoms include anal pain, an anal mass, or bleeding. As such, the disease is usually detected on rectal examination of patients with other suspected anorectal diseases. However, due to its rarity and nonspecific symptoms, melanoma of the rectal mucosa is easily misdiagnosed.
This report describes the case of a 58-year-old female patient who presented with a history of blood in her stool for the prior one or two months, without any identifiable cause. During colonoscopy, a bulge of approximately 2.2 cm × 2.0 cm was identified. Subsequently, the patient underwent endoscopic ultrasound (EUS) to characterize the depth of invasion of the lesions. EUS suggested a hypoechoic mucosal mass with involvement of the submucosal layer and heterogeneity of the internal echoes. Following surgical intervention, the excised tissue samples were examined and confirmed to be rectal malignant melanoma. The patient recovered well with no evidence of recurrence during follow-up.
This case shows that colonoscopy with EUS and pathological examination can accurately diagnose rare cases of rectal mucosal melanoma.
直肠黏膜黑色素瘤是一种罕见且侵袭性很强的疾病。常见症状包括肛门疼痛、肛门肿物或出血。因此，该病通常在对患有其他疑似肛肠疾病的患者进行直肠检查时被发现。然而，由于其罕见性和非特异性症状，直肠黏膜黑色素瘤很容易被误诊。
本报告描述了一名58岁女性患者的病例，该患者在过去一两个月有便血史，无任何明确病因。在结肠镜检查期间，发现一个约2.2厘米×2.0厘米的隆起。随后，患者接受了内镜超声检查（EUS）以确定病变的浸润深度。EUS显示为低回声黏膜肿物，累及黏膜下层且内部回声不均匀。手术干预后，对切除的组织样本进行检查，确诊为直肠恶性黑色素瘤。患者恢复良好，随访期间无复发迹象。
该病例表明，结肠镜检查联合EUS及病理检查可准确诊断罕见的直肠黏膜黑色素瘤病例。
