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一例原发性无色素性黑色素瘤伴远处转移的罕见有趣病例报告。

An Interesting Rare Case Report of Primary Amelanotic Melanoma With Distant Metastasis.

作者信息

Singh Kenneth, Gopinathan Athira, R Sivamarieswaran

机构信息

General Surgery, SRM Medical College Hospital and Research Centre, Chennai, IND.

出版信息

Cureus. 2024 Oct 31;16(10):e72803. doi: 10.7759/cureus.72803. eCollection 2024 Oct.

Abstract

Anorectal malignant melanoma (ARMM) is a rare and highly aggressive type of melanoma that originates in the anorectal area. It represents a small fraction of all melanoma cases and is often associated with poor prognosis due to its late presentation and challenging treatment options. Rectal malignant melanoma typically presents with symptoms such as rectal bleeding, pain, and obstructive symptoms. Diagnostic imaging and histopathological examination are crucial for accurate diagnosis, often requiring a combination of endoscopy, biopsy, and immunohistochemical staining. Treatment primarily involves surgical resection, though adjuvant therapies such as chemotherapy, immunotherapy, and radiation may be utilized depending on disease stage and metastasis. The prognosis remains guarded, with survival rates significantly lower compared to cutaneous melanoma, attributed to late-stage diagnosis and high likelihood of metastatic spread. Here we are reporting a case of ARMM presenting late with lung, skeletal, and liver metastasis.

摘要

肛管恶性黑色素瘤(ARMM)是一种罕见且侵袭性很强的黑色素瘤,起源于肛管区域。它在所有黑色素瘤病例中占比很小,由于其出现较晚且治疗选择具有挑战性,往往预后较差。直肠恶性黑色素瘤通常表现为直肠出血、疼痛和梗阻症状等。诊断性影像学检查和组织病理学检查对于准确诊断至关重要,通常需要内镜检查、活检和免疫组织化学染色相结合。治疗主要包括手术切除,不过根据疾病分期和转移情况,可能会采用化疗、免疫治疗和放疗等辅助治疗。预后仍然不容乐观,与皮肤黑色素瘤相比,生存率显著较低,这归因于晚期诊断和转移扩散的高可能性。在此,我们报告一例出现肺、骨骼和肝转移的晚期ARMM病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f97b/11608915/e8549e39c11e/cureus-0016-00000072803-i01.jpg

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