Jiang Xuejun, Ji Zujin, Li Peng, Yuan Fangjun, Lei Xinyi, Yang Yong
Department of Colorectal and Anal Surgery, Sinopharm Dongfeng General Hospital, Hubei University of Medicine, Shiyan, Hubei, China.
Department of Medical Ultrasonics, Sinopharm Dongfeng General Hospital, Hubei University of Medicine, Shiyan, Hubei, China.
Front Oncol. 2025 Jan 24;15:1465645. doi: 10.3389/fonc.2025.1465645. eCollection 2025.
Anorectal malignant melanoma is a rare subtype of melanoma with a poor prognosis. Despite this, some patients decline Miles' operation due to the sigmoid colostomies that follow abdominoperineal resections in cases of anorectal malignant melanoma.
We report the case of an 80-year-old woman diagnosed with anorectal malignant melanoma who underwent cryosurgery accompanied by adjuvant PD-1 therapy to maintain anal sphincter function. The results indicated that we successfully achieved the goal of sphincter preservation and therapeutic efficacy. The patient derived significant benefits from the cryoablation treatment.
Ultrasound-guided trans-anal cryoablation, when combined with adjuvant PD-1 therapy, offers a novel treatment approach for patients with anorectal malignant melanoma. Our results have confirmed the advantages of this treatment regimen, particularly for those desiring to retain anal sphincter function. Further studies are required to substantiate the efficacy of ultrasound-guided trans-anal cryoablation with adjuvant Toripalimab and to elucidate its underlying mechanisms.
肛管直肠恶性黑色素瘤是黑色素瘤的一种罕见亚型，预后较差。尽管如此，在肛管直肠恶性黑色素瘤病例中，一些患者因腹会阴切除术后的乙状结肠造口术而拒绝行迈尔斯手术。
我们报告了一例80岁女性被诊断为肛管直肠恶性黑色素瘤，该患者接受了冷冻手术并辅以PD -1治疗以维持肛门括约肌功能。结果表明，我们成功实现了保留括约肌功能和治疗效果的目标。患者从冷冻消融治疗中获得了显著益处。
超声引导下经肛门冷冻消融联合辅助性PD -1治疗为肛管直肠恶性黑色素瘤患者提供了一种新的治疗方法。我们的结果证实了这种治疗方案的优势，特别是对于那些希望保留肛门括约肌功能的患者。需要进一步研究来证实超声引导下经肛门冷冻消融联合辅助性托瑞帕利单抗的疗效，并阐明其潜在机制。
