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肛管直肠黑色素瘤

Melanoma of the anorectal region.

作者信息

Bolivar J C, Harris J W, Branch W, Sherman R T

出版信息

Surg Gynecol Obstet. 1982 Mar;154(3):337-41.

PMID:7064068
Abstract

Anorectal melanomas are more aggressive and behave differently from melanomas of the skin. Abdominoperineal amputation of the rectum is the favored procedure for potentially curable patients. Local recurrence in anorectal melanoma is less frequent in patients treated by local or wide excision of the tumor. Improvement in the primary anorectal melanoma survival rate appears to be dependent closely upon early diagnosis. Assessing the penetration of the tumor by the microstaging technique provides important prognostic information and serves for establishing indications for abdominoperineal amputation of the rectum in patients with primary anorectal melanoma. Two patients had a five year local and regional control of a primary anorectal melanoma achieved by abdominoperineal amputation of the rectum without groin dissection. One patient, free of disease, had an adenosquamous carcinoma of the lung develop with metastases to the skin. The carcinoma of the lung was considered as a secondary primary, which caused the death of the patient five years and nine months after the abdominoperineal amputation of the rectum.

摘要

肛管直肠黑色素瘤比皮肤黑色素瘤更具侵袭性,行为方式也有所不同。对于有可能治愈的患者,直肠腹会阴切除术是首选手术方式。在接受肿瘤局部或广泛切除治疗的患者中,肛管直肠黑色素瘤的局部复发较少见。肛管直肠黑色素瘤原发灶生存率的提高似乎密切依赖于早期诊断。通过微分期技术评估肿瘤浸润深度可提供重要的预后信息,并有助于确定原发性肛管直肠黑色素瘤患者行直肠腹会阴切除术的指征。两名患者通过直肠腹会阴切除术且未行腹股沟淋巴结清扫,实现了原发性肛管直肠黑色素瘤长达五年的局部和区域控制。一名患者无疾病复发,但发生了肺腺鳞癌并转移至皮肤。肺部肿瘤被认为是第二原发肿瘤,导致该患者在直肠腹会阴切除术后五年零九个月死亡。

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