Primary Anorectal Melanoma: Report of a Case

原發性肛門直腸黑色素瘤：一病例報告

曾國枝(Kuo-Chih Tseng) ； 鄭斌男(Pin-Nan Cheng) ； 李伯璋(Po-Chang Lee) ； 蔡宏名(Hong-Ming Tsai) ； 戴元昌(Yuan-Chang Dai)

《中華民國消化系醫學雜誌》 18卷4期 (2001/12) Pp. 266-271

https://doi.org/10.6557/GJTb.200112_18(4).0004

摘要

原發性肛門直腸黑色素瘤是一種少見，具侵犯性的惡性腫瘤。下消化道出血是最常見的表癥。在此我們提出一例報告：一位有肝硬化病史之七十歲女性因血便至醫院就診，大腸鏡檢發現在肛門邊緣以上3公分處有一3公分大小之灰黑色的腫塊，經病理診斷為黑色素瘤。系列檢查並發現它處之轉移。隨後此病患接受局部腫瘤切除，術後恢復良好並追蹤至今已三十個月，並無腫瘤復發之情形。因此，若患者出現下消化道出血及大腸鏡檢發現黑色的腫塊應懷疑原發性肛門直腸黑色素瘤。對於肝硬化或其它慢性病之病人，為保有良好之生活品質與減少術中或術後併發症，局部切除應為另一選擇之手術方法。

關鍵字

肛門直腸 ； 黑色素瘤

並列摘要

Primary anorectal melanoma is a rare, but aggressively malignant tumor. The most common manifestation is lower gastrointestinal bleeding. We report a case of a 70-year-old female with cirrhosis of liver who presented with hematochezia, and on Colonoscopy was found to have a brown-grayish protruding anorectal mass that proven to be a melanoma. A series of imaging studies revealed no evidence of extra-luminal invasion, lymph node metastasis, and distant dissemination of tumor. Thereafter, the tumor was removed by trans-anal excision. The patient remained well without any evidence of tumor recurrence during a 30-month follow-up. We suggest that primary anorectal melanoma should be suspected in patients with concomitant presence of lower gastrointestinal bleeding and pigmented anorectal tumor. In order to preserve quality of life, and lessen operative morbidity, a conservative local excision might be a treatment option for primary anorectal melanoma, particularly in debilitated patients.

並列關鍵字

anorectum ； melanoma