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肛管直肠黑色素瘤:两例报告。

Anorectal melanoma: Report of two cases.

作者信息

El Achchi Anass, Majdoubi Amine, El Hammouti Mohamed, Bouhout Tarek, Serji Badr

机构信息

Surgical Oncology Department, Regional Oncology Center, Mohammed VI University Hospital, Oujda, Morocco; Mohammed First University Oujda, Faculty of Medicine and Pharmacy Oujda, Oujda, Morocco.

Surgical Oncology Department, Regional Oncology Center, Mohammed VI University Hospital, Oujda, Morocco; Mohammed First University Oujda, Faculty of Medicine and Pharmacy Oujda, Oujda, Morocco.

出版信息

Int J Surg Case Rep. 2025 Jan;126:110621. doi: 10.1016/j.ijscr.2024.110621. Epub 2024 Nov 19.

Abstract

INTRODUCTION

Anorectal melanoma (AM) is a rare and aggressive type of cancer. Its symptoms often resemble those of common benign anal conditions, such as hemorrhoids, leading to frequent delays in diagnosis. Consequently, about one-third of patients have metastases at the time of their initial diagnosis. The primary treatment for AM is surgical resection, while adjuvant therapies may include immunotherapy, radiotherapy, brachytherapy, and chemotherapy. The prognosis for AM is poor, with a five-year survival rate of only 20 %.

CASE PRESENTATION

In this study, we report two cases of patients who experienced different anorectal symptoms for a long time before their condition worsened, prompting further investigation that revealed a diagnosis of malignant anorectal melanoma. Both patients underwent surgical resection and are currently receiving adjuvant therapy.

DISCUSSION

This article discusses the prognosis of anorectal melanoma, the current lack of consensus on treatment protocols, and the importance of maintaining a high index of suspicion for early diagnosis.

CONCLUSION

Anorectal melanoma is a rare pathology, and its prognosis is poor due to the frequent presence of metastatic forms at the time of diagnosis. Surgery, whether through abdominoperineal amputation or wide local excision, is the treatment of choice for these tumors. The use of radiotherapy (RT) is controversial and is currently indicated either as hypofractionated therapy following local excision (EL) or as palliative treatment.

摘要

引言

肛管直肠黑色素瘤(AM)是一种罕见且侵袭性强的癌症类型。其症状常与常见的良性肛门疾病(如痔疮)相似,导致诊断频繁延迟。因此,约三分之一的患者在初次诊断时已有转移。AM的主要治疗方法是手术切除,辅助治疗可能包括免疫治疗、放射治疗、近距离放射治疗和化疗。AM的预后较差,五年生存率仅为20%。

病例介绍

在本研究中,我们报告了两例患者,他们在病情恶化前长时间经历了不同的肛管直肠症状,促使进一步检查后确诊为恶性肛管直肠黑色素瘤。两名患者均接受了手术切除,目前正在接受辅助治疗。

讨论

本文讨论了肛管直肠黑色素瘤的预后、目前治疗方案缺乏共识以及对早期诊断保持高度怀疑指数的重要性。

结论

肛管直肠黑色素瘤是一种罕见的病理类型,由于诊断时经常存在转移形式,其预后较差。手术,无论是经腹会阴切除术还是广泛局部切除术,都是这些肿瘤的首选治疗方法。放射治疗(RT)的使用存在争议,目前适用于局部切除(EL)后的低分割治疗或姑息治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ad2/11718282/c532aa36c5ec/gr1.jpg

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