Multiple synchronous anorectal melanomas with different colors: A case report
Multiple synchronous anorectal melanomas with different colors: A case report
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DOI：
10.12998/wjcc.v7.i11.1337
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发表时间：
2019-06-06
影响因子：
1.1
通讯作者：
Guo, Shan-Yu
中科院分区：
文献类型：
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作者：
Cai, Yan-Tao;Cao, Li-Chen;Guo, Shan-Yu
背景肛门直肠黑色素瘤（AM）是一种极其罕见的起源于肛门直肠黑色素细胞的恶性肿瘤，预后较差。据报道，AM 的发病率远低于皮肤或脉络膜黑色素瘤，占所有黑色素瘤的 0.4%-1.6%。 病例摘要我们报告一名 76 岁女性患者，经结肠镜检查和活检诊断为肛门直肠恶性黑色素瘤。术中检查发现两种不同的肛门直肠肿瘤，一种是黑色素瘤，另一种是无黑色素瘤，以及齿状线水平的两个色素沉着的粘膜区。进行了腹会阴切除术。病理报告证实所有四个病变均为黑色素瘤。术后，我们遵循针对 PD-1（纳武单抗）的免疫治疗方案。完成纳武单抗治疗后，该患者进行了 24 个月的无病随访。 结论 这是首例报告的同一患者同时存在色素性和非色素性 AM 的病例。
BACKGROUNDAnorectal melanoma (AM) is an extremely rare malignant tumor originating from anorectal melanocytes with a poor prognosis. AM has been reported to have a much lower incidence than cutaneous or choroid melanoma, accounting for 0.4%-1.6% of all melanomas.CASE SUMMARYWe report a 76-year-old female patient diagnosed with anorectal malignant melanoma by colonoscopy and biopsy. Intraoperative examination revealed two distinct anorectal tumors, one melanotic and another amelanotic, as well as two pigmented mucosal zones at the dentate line level. Abdominal perineal resection was performed. A pathological report confirmed all four lesions to be melanomas. Postoperatively, we followed an immunotherapy protocol targeting PD-1 (nivolumab). The patient had 24 mo of disease-free follow-up upon completion of nivolumab treatment.CONCLUSIONThis is the first reported case presenting coexistence of pigmented and unpigmented AMs in the same patient.