Nemer F D, Stoeckinger J M, Evans O T
Dis Colon Rectum. 1977 Jul-Aug;20(5):405-13. doi: 10.1007/BF02587373.
Five cases of smooth-muscle rectal tumors seen in the Lexington, Kentucky, area over a 25-year period are reported. These unusual tumors cause symptoms similar to those of more common anorectal diseases, namely, painful defecation and rectal bleeding. Often these tumors are initially asymptomatic due to their submucosal origin. Clinical diagnosis depends on awareness of these lesions, digital rectal examination, endoscopic examination, and tissue biopsy. Microscopic diagnosis and differentiation of malignant from benign features require a pathologist with special interest and expertise with these lesions. Smooth-muscle rectal tumors should be considered more dangerous than those in other locations in the gastrointestinal tract, as half are malignant and only a fifth of patients who have sarcomas survive five years. Treatment of malignant rectal myomas should be very aggressive from the outset, with abdominoperineal resection being advocated by most investigators due to almost uniform local recurrence with lesser procedures. When the lesion recurs, it is likely to be more virulent histologically and clinically than the initial lesion. Benign myomas are cured by local excision alone.
报告了肯塔基州列克星敦地区在25年期间所见的5例直肠平滑肌肿瘤。这些不常见的肿瘤引起的症状与更常见的肛肠疾病相似，即排便疼痛和直肠出血。由于这些肿瘤起源于黏膜下，通常最初无症状。临床诊断取决于对这些病变的认识、直肠指检、内镜检查和组织活检。恶性与良性特征的显微镜诊断和鉴别需要对这些病变有特殊兴趣和专业知识的病理学家。直肠平滑肌肿瘤应被认为比胃肠道其他部位的更危险，因为一半是恶性的，患肉瘤的患者只有五分之一能存活5年。恶性直肠肌瘤的治疗从一开始就应非常积极，大多数研究者主张行腹会阴切除术，因为采用较小的手术几乎都会局部复发。当病变复发时，其在组织学和临床上可能比初始病变更具侵袭性。良性肌瘤仅通过局部切除即可治愈。
