直肠肛管恶性黑色素瘤的诊治  

Evaluation of diagnosis and treatment of colorectal malignant melanoma

作　　者：张浩波[1] 冯国光[1] 邹鸿志[1] 郁宝铭[1] 

机构地区：[1]上海第二医科大学附属瑞金医院外科,200025

出　　处：《临床外科杂志》2002年第3期139-140,共2页Journal of Clinical Surgery

摘　　要：目的　探讨直肠肛管恶性黑色素瘤的临床表现、诊断、治疗及预后。方法　回顾性分析了 1981～ 1996年我科诊治的直肠肛管恶性黑色素瘤 6例 ,并进行随访。结果　 6例患者肿块位于齿状线附近 ,肉眼观为紫黑色或褐色 ,均行手术治疗 ,其中 2例行Mile’s术 ,2例行后盆腔清扫术 ,1例行经肛门肿块局部扩大切除术 ,1例行剖腹探查术 ,所有患者手术时均已有淋巴结或肝脏转移。 6例患者于确诊后 5～ 2 3个月死亡 ,平均存活 14 .7个月。结论　直肠肛管恶性黑色素瘤恶性度极高 ,死亡率高 ,较早发生淋巴和血行转移 。Objective To study the symptoms, diagnosis, treatment and prognosis of colorectal malignant melanoma.Methods Six cases of colorectal malignant melanoma diagnosed and treated in our department between 1981 and 1996 were reviewed and underwent follow-up.Results All cases had masses that could be found near dentate line in digital examination and were black or brown in color. All patients underwent operations ,operations abdomino-perineal resection for 2 cases, post pelvic excision for 2 cases, enlarged local resection for 1 case and laporotomy for 1 case.Either lymph node metastasis or liver metastasis were found prior to or during operation. All patients died within 5～23 months after being diagnosed, with average survival time of 14.7 months.Conclusions Colorectal malignant melanoma was rare and was highly of malignant with tendency of early metastasis and poor prognosis. Radical surgery combined with chemotherapy, immunotherapy and biotherapy may be effective.

关 键 词：直肠肛管恶性黑色素瘤 诊断 治疗 

分 类 号：R735.37[医药卫生—肿瘤]