Cooper P H, Mills S E, Allen M S
Dis Colon Rectum. 1982 Oct;25(7):693-703. doi: 10.1007/BF02629543.
The authors present a report of 12 patients with anal melanoma (AM) and review 255 cases reported since 1947. Combining these patients with those from the literature, the authors analyze several aspects of AM that are controversial or have not been studied in a systematic manner. The mean clinical tumor size was 4.1 cm. Seventy per cent were grossly pigmented, 63 per cent were polypoid, and 44 per cent were prolapsed. Two-thirds of AM were located in the proximal pecten, at or near the level of the anal valves. Microscopically, the most useful diagnostic criteria were melanin production, junctional change, and a nesting growth pattern. In four of the authors' cases, atypical junctional change extended laterally from the overt invasive neoplasm for distances up to 1 cm. Approximately 60 per cent of patients had metastases at the time of diagnosis. There was no statistical difference in determinate survivals of patients treated for cure by local excision and abdominoperineal resection. Neither tumor size nor configuration affected survival. The choice of therapy was not influenced by tumor size.
作者报告了12例肛门黑色素瘤（AM）患者，并回顾了自1947年以来报告的255例病例。将这些患者与文献中的患者相结合，作者分析了AM的几个有争议或尚未系统研究的方面。临床肿瘤平均大小为4.1厘米。70%有明显色素沉着，63%呈息肉样，44%有脱垂。三分之二的AM位于直肠近端，在肛门瓣水平或其附近。显微镜下，最有用的诊断标准是黑色素生成、交界性改变和巢状生长模式。在作者的4例病例中，非典型交界性改变从明显的浸润性肿瘤侧向延伸达1厘米。约60%的患者在诊断时已有转移。局部切除和腹会阴切除治疗以治愈为目的的患者的确定生存率无统计学差异。肿瘤大小和形态均不影响生存。治疗方法的选择不受肿瘤大小的影响。
