Delikaris P, Koutmeridis D, Tsonis G, Asimaki A, Mouratidou D
B' Surgical Department, G. Papanikolaou General Hospital, Thessaloniki, Greece.
Dis Colon Rectum. 1997 Jan;40(1):105-8. doi: 10.1007/BF02055691.
Synchronous neoplasms of the rectum are an uncommon condition. The situation becomes more rare when tumors are of different origin. To the authors' knowledge, synchronous anorectal melanoma and adenocarcinoma of the rectum have not been reported in the literature before.
A 67-year-old female patient with synchronous anorectal malignant melanoma and adenocarcinoma of the rectum is described. She had preoperative colonoscopic diagnosis. The different neoplasms' origin was histologically proven. Surgical management consisted of abdominoperineal resection of the rectum. Postoperatively, the patient received adjuvant chemotherapy of six cycles duration. At present, the patient has completed 32 months of follow-up. There is no evidence of recurrent disease or distant metastases.
Review of the literature confirms the rarity of anorectal malignant melanoma. On the other hand, the rectum represents the most common site for development of colonic adenocarcinoma. We were unable to trace synchronous presentation of these two tumors. Prognosis should be defined by the most malignant neoplasm; therefore, management should be focused on treating the melanoma.
直肠同时性肿瘤是一种罕见的情况。当肿瘤起源不同时，这种情况更为罕见。据作者所知，此前文献中尚未报道过同时性肛管直肠黑色素瘤和直肠腺癌。
本文描述了一名67岁患有同时性肛管直肠恶性黑色素瘤和直肠腺癌的女性患者。她术前经结肠镜检查确诊。不同肿瘤的起源经组织学证实。手术治疗包括直肠腹会阴联合切除术。术后，患者接受了为期六个周期的辅助化疗。目前，患者已完成32个月的随访。没有复发疾病或远处转移的证据。
文献回顾证实肛管直肠恶性黑色素瘤罕见。另一方面，直肠是结肠腺癌最常见的发病部位。我们未能查到这两种肿瘤的同时性表现。预后应由最恶性的肿瘤决定；因此，治疗应侧重于治疗黑色素瘤。
