直肠肛管恶性黑色素瘤的临床特征分析  

Clinical analysis of anorectal malignant melanoma

作　　者：张森[1] 高枫[1] 陈利生[1] 唐宗江[1] 梁君林[1] 吴全[1] 

机构地区：[1]广西医科大学第一附属医院大肠肛门病外科,南宁530021

出　　处：《中华胃肠外科杂志》2005年第4期309-311,共3页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的了解原发性直肠肛管恶性黑色素瘤的临床特点。方法回顾性分析9例原发性直肠肛管恶性黑色素瘤的临床资料,并复习文献。结果直肠肛管恶性黑色素瘤以女性多见,平均发病年龄56岁,病程5.8个月;首发症状以血便为最常见,其次为肛门肿物突出。94.7%的直肠肛管恶性黑色素瘤在距离肛缘5.0cm范围内;肿瘤最大径(3.3±2.1)cm;其中54.5%可活动;有19.1%的肿瘤表面光滑;6.6%的肿瘤质地软;14.0%同期发现转移,肝转移最常见,腹股沟淋巴结转移其次;的病例出现误诊,超过者被误诊为良性疾病;手术治疗中以Miles术为主,经肛门局部切除术其次。结论直肠肛管恶性黑色素瘤极易误诊。手术治疗为主。Objective To summarize the clinicopathological characteristics of primary anorectal malignant melanoma(AMM). Methods Clinical data of nine patients with AMM were reviewed retrospectively from January 1999 to March 2005. Results Anorectal malignant melanoma had a female predominance. The average age was 56 years old and average course of disease was 5.8 months. The onset of symptom was hematochezia,then anus prolapses. 94.7% of patients had AMM within 5 cm from anus margin; the average tumor size was (3.3± 2.1)cm. The polyp and ulcer were most common types. More than a half (54.5% ) of the tumor was movable, 19.1% smooth surfaced, 6.6% soft textured. Synchronous metastasis was found in 14.0% of the patients,the first common metastasis was found in liver,the secondary was superficial inguinal lymph node metastasis. Half of the patients were misdiagnosed,and over 50% of patients were misdiagnosed as benign disease. Mile’ s operation was performed in most of patients(63% ),while anal resection was performed in 30% of the patients. Conclusion Anorectal malignant melanoma is often misdiagnosed,surgical procedure is the first choice for patients with AMM.

关 键 词：直肠肛管恶性黑色素瘤 临床特征分析 腹股沟淋巴结转移 经肛门局部切除术 MILES术 手术治疗 回顾性分析 临床特点 临床资料 发病年龄 首发症状 肿瘤质地 良性疾病 原发性 最大径 肝转移 误诊为 易误诊 

分 类 号：R735.3[医药卫生—肿瘤]