直肠肛管恶性黑色素瘤1例报告  

A Case Report of Anorectal Malignant Melanoma

作　　者：栾立鹏 陈俊杰[1] 顾闻[1] 张海涛(指导)[1] 何宋兵[1] LUAN Li-peng;CHENG Jun-jie;GU Wen;ZHANG Hai-tao;HE Song-bing(Department of General Surgery,the First Affliated Hospital of Soochow University,Suzhou,Jiangsu,215006,China)

机构地区：[1]苏州大学附属第一医院普外科,江苏苏州215006

出　　处：《中国血液流变学杂志》2019年第3期277-280,302,共5页Chinese Journal of Hemorheology

基　　金：国家自然科学基金项目(81672348);江苏省自然科学基金项目(BK20191172);江苏省“科教强卫工程”青年医学人才项目(QNRC2016735);吴阶平医学基金(320.6750.17276)。

摘　　要：目的 探讨直肠肛管恶性黑色素瘤(anorectal malignant melanoma,ARMM)的病因、临床特点、诊断方式及治疗方案.方法 通过对于收住的1例ARMM患者临床病历资料进行回顾性分析并通过查找、复习相关文献进行总结.结果 该例患者因发现直肠肿物半月余入院,入院后指检距肛门2 cm可及一质硬肿物,腹部CT显示直肠壁稍增厚.完善其他检查,于全麻下行腹腔镜下直肠癌根治术(miles术式)+双侧腹股沟区淋巴结清扫术,术后常规病理示:(直肠)恶性黑色素瘤,腹股沟淋巴结未见转移.结论 ARMM属于黏膜黑色素瘤的一种,发病率低,早期症状不典型,多数患者就诊时肿瘤已处于中晚期;病理诊断是ARMM的金标准,对于疑似病人应常规指检,必要时完善肠镜及病理活检,对于确诊病人应积极手术并根据术后病理决定进一步治疗方案.Objective To explore the etiology,clinical characteristics,diagnosis and treatment of anorerectal malignant melanoma(ARMM).Methods A retrospective analysis was conducted on the clinical medical records of one ARMM patient admitted to the general surgery department,and a summary was made by searching and reviewing relevant literatures.Results The patient was admitted to the hospital for more than half a month due to the presence of rectal mass.Physical examination showed a hard mass 2 cm away from the anus.Abdominal CT showed that the rectal wall was slightly thickened.After completion of other examinations,laparoscopic radical resection of rectal cancer(miles operation)plus bilateral inguinal lymph node dissection under general anesthesia was carried out.Postoperative routine pathology showed that it was rectal malignant melanoma and no inguinal lymph node metastasis.Conclusion ARMM is a type of mucosal melanoma with low incidence and atypical early symptoms.Pathological diagnosis is the gold standard of ARMM.Biopsy should be taken when necessary for the suspected patients,and active surgery should be performed for the confirmed patients and further treatment plan should be determined according to the postoperative pathology.

关 键 词：直肠肛管 恶性 黑色素瘤 临床特点 诊断 治疗 

分 类 号：R735.37[医药卫生—肿瘤]