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Yan J, Jing J, Wu S, Geiru L, Zhuang H. Can transrectal ultrasonography distinguish anorectal malignant melanoma from low rectal adenocarcinoma? A retrospective paired study for ten years. BMC Gastroenterol 2022; 22:165. [PMID: 35382743 PMCID: PMC8985288 DOI: 10.1186/s12876-022-02237-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 03/24/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Anorectal malignant melanoma (ARMM) and low rectal adenocarcinoma (LRAC) have some similarities in clinical behaviors, histopathological characteristics and ultrasonographic findings, diagnostic errors are common. By comparing the transrectally ultrasonographic features between the two tumors, we propose to provide more possibilities in differentiating them. METHODS The data of 9 ARMMs and 27 age- and gender-matched LRACs (the lower margin below the peritoneal reflection) in West China Hospital Sichuan University between April 2008 and July 2019 were retrospectively reviewed. The ultrasonic features between the two groups were compared. RESULTS Transrectal ultrasonography (TRUS) showed that the length of ARMM was shorter than that of LRAC (28.22 ± 12.29 mm vs. 40.22 ± 15.16 mm), and ARMM had a lower position than that of LRAC (the distance to anal verge was 50.78 ± 11.70 vs. 63.81 ± 18.73 mm). Unlike LRAC, the majority of ARMM in our study was confined to the intestinal mucosa/submucosa (66.67/25.93%) (P < 0.05). CONCLUSIONS Based on the data of our study, several ultrasonographic findings (length, invasion depth, and position) of ARMM were significantly different from LRAC. Accordingly, more attention should be paid to masses at anorectal junction with lower position, shorter length, and shallower infiltration depth. Instead of the most common tumor, LRAC, ARMM should be taken into account to avoid a misdiagnosis, which will result in a poorer prognosis.
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Affiliation(s)
- Jingwen Yan
- Department of Diagnostic Ultrasound, West China Hospital, Sichuan University, No. 37 Guoxue Road, Wuhou District, Chengdu, 610041, Sichuan Province, China
| | - Jigang Jing
- Department of Diagnostic Ultrasound, West China Hospital, Sichuan University, No. 37 Guoxue Road, Wuhou District, Chengdu, 610041, Sichuan Province, China
| | - Shuang Wu
- Department of Diagnostic Ultrasound, West China Hospital, Sichuan University, No. 37 Guoxue Road, Wuhou District, Chengdu, 610041, Sichuan Province, China
| | - Lacong Geiru
- Department of Diagnostic Ultrasound, West China Hospital, Sichuan University, No. 37 Guoxue Road, Wuhou District, Chengdu, 610041, Sichuan Province, China
| | - Hua Zhuang
- Department of Diagnostic Ultrasound, West China Hospital, Sichuan University, No. 37 Guoxue Road, Wuhou District, Chengdu, 610041, Sichuan Province, China.
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Takahashi M, Morita Y, Hayashi T, Yanagibasi S, Sato S, Sasaki S, Takuma K, Okada H. A case of laparoscopic partial hepatic S7 resection for postoperative liver metastasis of rectal malignant melanoma. Surg Case Rep 2021; 7:230. [PMID: 34704187 DOI: 10.1186/s40792-021-01316-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 10/19/2021] [Indexed: 12/03/2022] Open
Abstract
Background Anorectal malignant melanoma (ARMM) has an extremely poor prognosis, and there is no report of resection of liver metastases so far. We report herein a rare case of postoperative laparoscopic partial hepatic S7 resection for rectal malignant melanoma. Case presentation A 51-year-old female patient with a diagnosis of an ARMM underwent a laparoscopic rectal amputation. Eleven months later, computed tomography (CT) revealed a 14-mm nodule in liver segment 7 (S7), which was diagnosed as a hepatic recurrence of the ARMM. Because no other recurrences were found, a laparoscopic partial resection of S7 was performed. Pathological analysis found intracellular melanin deposition, and immunostaining was S-100 (+), HMB-45 (+), and SOX-10 (+). Based on these findings, a liver metastasis of malignant melanoma was diagnosed. The patient is alive 7 months after the second surgery and has so far experienced no recurrences. Conclusion We reported an extremely rare case of a laparoscopic resection of a liver metastasis following surgery for ARMM.
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Pişkin E, Aydın O, Şenlikçi A, Özgün MY, Öter V, Bostancı EB. Primary anorectal malignant melanomas: retrospective analysis of 11 cases in a single center. Turk J Surg 2021; 37:63-67. [PMID: 34585096 DOI: 10.47717/turkjsurg.2021.4810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 08/12/2020] [Indexed: 11/23/2022]
Abstract
Objectives Anorectal malignant melanoma is a rare tumor with poor prognosis. In this study, it was aimed to present our surgical results by reviewing the literature retrospectively in 11 patients who underwent surgery for ARMM in our clinic. Material and Methods The patients who underwent surgery for anorectal malignant melanoma in Yuksek İhtisas Training and Research Hospital between 2007-2018 were included in the study. Results Four patients were males and seven were females. Mean age was 54.18. The tumor was in the rectum in 4 cases, in the anorectal region in 3 cases and in the anal canal in 4 cases. Wide local excision was performed in 3 cases and APR was performed in 8 cases. Four of the cases were stage I, 6 were stage II and 1 was stage III. Mean tumor size was 4.73 cm, and mean tumor depth was 13.6 mm. Mean number of metastatic lymph nodes was 10.37. Median survival was 12 months. Conclusion Anorectal malignant melanoma is a type of tumor diagnosed in late and advanced stages due to lack of specific findings. Although ARMM is rare, when rectal bleeding, pain, hemorrhoids and changes in bowel habits are observed, ARMM should be kept in mind.
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Affiliation(s)
- Erol Pişkin
- Clinic of Surgical Gastroenterology, Ankara City Hospital, Ankara, Turkey
| | - Osman Aydın
- Clinic of Surgical Gastroenterology, Ankara City Hospital, Ankara, Turkey
| | - Abdullah Şenlikçi
- Clinic of Surgical Gastroenterology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Mehmet Yiğit Özgün
- Clinic of Surgical Gastroenterology, Ankara City Hospital, Ankara, Turkey
| | - Volkan Öter
- Clinic of Surgical Gastroenterology, Ankara City Hospital, Ankara, Turkey
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Futori T, Enomoto T, Owada Y, Ohara Y, Matsumura H, Oda T. Locally advanced anorectal malignant melanoma in septuagenarian patient treated by laparoscopic abdominoperineal resection: A case report. Int J Surg Case Rep 2021; 87:106378. [PMID: 34536769 PMCID: PMC8449173 DOI: 10.1016/j.ijscr.2021.106378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/26/2021] [Accepted: 09/02/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction Anorectal malignant melanoma (ARMM) is a rare disease with a poor prognosis. In cases involving locally advanced disease, the treatment strategy is difficult, especially in octogenarian patients, because the prognosis is poor, despite the corresponding decrease or loss of the anal function. Presentation of case A 78-year-old woman was admitted to a local hospital with chief complaints of severe anal discomfort due to an egg-sized tumor that was protruding out of the anus and melena. A diagnosis of ARMM was confirmed based on the examination of biopsy specimens and imaging study showed swollen lymph nodes on the dorsal side of the middle rectum and left internal iliac lymph nodes. Laparoscopic abdominoperineal resection with left lateral lymph node dissection was performed. The examination of the resected specimen revealed two polypoid tumors with a maximum diameter of 38 mm and 14 mm with a metastatic lymph node of 62 mm in the mesorectum. The postoperative course was uneventful. Relapse and local recurrence free survival without any complaints was obtained for more than 12 months. Discussion With respect to locoregional disease control, it has been reported that abdominoperineal resection can obtain better control of local disease in comparison to local resection. Laparoscopic surgery is advantageous in its facilitation of an early postoperative recovery for elderly patient. Conclusion Laparoscopic abdominoperineal resection may control locoregional disease and improve the patient's QOL with early postoperative recovery. —even in septuagenarian patients—may become a treatment strategy for advanced ARMM. Anorectal malignant melanoma is a rare disease with a poor prognosis. Surgical procedure for anorectal malignant melanoma is controversial. APR may achieve better local control for advanced anorectal malignant melanoma. Laparoscopic surgery is advantageous in its facilitation of an early recovery for elderly patient.
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Affiliation(s)
- Takuya Futori
- University of Tsukuba, Faculty of Medicine, Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, 1-1-1 Tennnodai, Tsukuba-shi, Ibaraki-ken 305-8575, Japan.
| | - Tsuyoshi Enomoto
- University of Tsukuba, Faculty of Medicine, Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, 1-1-1 Tennnodai, Tsukuba-shi, Ibaraki-ken 305-8575, Japan.
| | - Yohei Owada
- University of Tsukuba, Faculty of Medicine, Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, 1-1-1 Tennnodai, Tsukuba-shi, Ibaraki-ken 305-8575, Japan.
| | - Yusuke Ohara
- University of Tsukuba, Faculty of Medicine, Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, 1-1-1 Tennnodai, Tsukuba-shi, Ibaraki-ken 305-8575, Japan.
| | - Hideki Matsumura
- University of Tsukuba, Faculty of Medicine, Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, 1-1-1 Tennnodai, Tsukuba-shi, Ibaraki-ken 305-8575, Japan.
| | - Tatsuya Oda
- University of Tsukuba, Faculty of Medicine, Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, 1-1-1 Tennnodai, Tsukuba-shi, Ibaraki-ken 305-8575, Japan.
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Lv K, Le Q, Xia Y, Yao N. Surgery combined with teraplizumab for anorectal malignant melanoma: A case report. Asian J Surg 2021:S1015-9584(21)00520-0. [PMID: 34493424 DOI: 10.1016/j.asjsur.2021.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 08/10/2021] [Indexed: 11/22/2022] Open
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Nonaka K, Kudou K, Sasaki S, Jogo T, Hirose K, Kasagi Y, Hu Q, Tsuda Y, Hisamatsu Y, Ando K, Nakashima Y, Saeki H, Oki E, Kamori M, Mori M. Primary anorectal malignant melanoma with laparoscopic abdominoperineal resection: a case study and review of the relevant literature. Int Cancer Conf J 2020; 9:116-122. [PMID: 32582514 PMCID: PMC7297936 DOI: 10.1007/s13691-020-00401-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 02/13/2020] [Indexed: 12/18/2022] Open
Abstract
ARMM is a disease with a poor prognosis. ARMM is often diagnosed at an advanced stage, and the 5-year survival rate of ARMM is < 20%. Although the number of case reports on ARMM is gradually increasing, the optimal treatment strategy for ARMM remains controversial. We report the case of an 81-year-old woman who had experienced bloody stool for 6 months before her diagnosis and who had been initially diagnosed with hemorrhoids. The pathological diagnosis of a biopsy specimen was malignant melanoma. Other examinations showed no evidence of lymph node or distant metastasis. Based on these results, laparoscopic abdominoperineal resection was performed. Three months later on her first follow-up examination, distant metastasis to the lung and liver was detected. Immunotherapy using Nivolumab was initiated to treat the recurrent disease. We reviewed the characteristics of a total of 1834 ARMM patients described in previous reports on ARMM for which the full text was available on PubMed. We experienced a case of ARMM. The prognosis of ARMM is still poor, regardless of the surgical procedure. Previous studies and our case report suggest that systemic therapy, such as immunotherapy using an anti-PD-1 ligand may be more important than reinforcement of local control for improving the prognosis of ARMM patients.
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Affiliation(s)
- Kentaro Nonaka
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kensuke Kudou
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Endoscopy and Endoscopic Surgery, Fukuoka Dental College, 2-15-1 Tamura, Sawara-ku, Fukuoka, Fukuoka 814-0193 Japan
| | - Shun Sasaki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomoko Jogo
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kosuke Hirose
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yuta Kasagi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Qingjiang Hu
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasuo Tsuda
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yuichi Hisamatsu
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koji Ando
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yuichiro Nakashima
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroshi Saeki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Eiji Oki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mitsuo Kamori
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Kamori Clinic, Fukuoka, Japan
| | - Masaki Mori
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Tappero G, Parente R, Borghini R, Trecca A. A dark polyp in the anorectum. Tech Coloproctol 2019; 23:1097-9. [PMID: 31538296 DOI: 10.1007/s10151-019-02085-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 09/07/2019] [Indexed: 10/26/2022]
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Manabe S, Boku Y, Takeda M, Usui F, Hirata I, Takahashi S. Endoscopic submucosal dissection as excisional biopsy for anorectal malignant melanoma: A case report. World J Clin Cases 2019; 7:1652-1659. [PMID: 31367624 PMCID: PMC6658369 DOI: 10.12998/wjcc.v7.i13.1652] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/15/2019] [Accepted: 05/02/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Anorectal malignant melanoma (AMM) is a rare disorder with an extremely poor prognosis. Although there is currently no consensus on the treatment methods for AMM, surgical procedures have been the most common treatment methods used until now. We recently encountered a case of AMM that we diagnosed using endoscopic submucosal dissection (ESD). To our knowledge, this is the first case of ESD for AMM, suggesting that ESD can potentially be a diagnostic and treatment method for AMM.
CASE SUMMARY A 77-year-old woman visited our hospital with a chief complaint of anal bleeding and a palpable rectal mass. Colonoscopy revealed a 20-mm protruded lesion in the lower rectum. After obtaining biopsy specimens from the lesion, although a malignant rectal tumor was suspected, a definitive diagnosis was not made. Endoscopic ultrasonography revealed tumor invasion into the submucosal layer but not the muscular layer. Therefore, we performed an excisional biopsy using ESD. Immunohistochemical examination of the ESD-resected specimen revealed tumor cells positive for Human Melanin Black-45, Melan-A, and S-100. Moreover, the tumor cells lacked melanin pigment; thus, a diagnosis of amelanotic AMM was made. Although the AMM had massively invaded the submucosal layer and both lymphatic and venous invasion were present, we closely monitored the patient without any additional therapy on the basis of her request. Six months after ESD, local recurrence was detected, and the patient consented to wide local excision.
CONCLUSION It is suggested that ESD is a potential diagnostic and treatment method for AMM.
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Affiliation(s)
- Shigeo Manabe
- Department of Gastroenterology, Kouseikai Takeda Hospital, Kyoto 600-8558, Japan
| | - Yoshio Boku
- Fujita Clinic, 67, Gokiya-cho, Oomiya-dori Shichijo-kudaru, Shimogyo-ku, Kyoto 600-8267, Japan
| | - Michiyo Takeda
- Department of Gastroenterology, Kouseikai Takeda Hospital, Kyoto 600-8558, Japan
| | - Fumitaka Usui
- Department of Gastroenterology, Kouseikai Takeda Hospital, Kyoto 600-8558, Japan
| | - Ikuhiro Hirata
- Department of Gastroenterology, Kouseikai Takeda Hospital, Kyoto 600-8558, Japan
| | - Shuji Takahashi
- Department of Gastroenterology, Kouseikai Takeda Hospital, Kyoto 600-8558, Japan
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Serra M, Santos T, Martins M, Sardo L. Amelanocytic anorectal malignant melanoma-Case report. Int J Surg Case Rep 2019; 55:164-7. [PMID: 30739873 DOI: 10.1016/j.ijscr.2019.01.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 12/01/2018] [Accepted: 01/27/2019] [Indexed: 02/03/2023] Open
Abstract
Anorectal malignant melanoma, is a rare and aggressive form of melanoma. Very different from its cutaneous counterpart. There is no optimal treatment. Surgery is the mainstay of treatment, but the extent is controversial. Patient’s quality of life deserves attention when choosing the adequate surgical technic.
Introduction Anorectal malignant melanoma (AMM), is a rare and aggressive form of melanoma. Accounts for <2% of melanomas, and <2% of anal tumors. It is more frequent at the 6th–7th decade, mostly in women. Surgery is the mainstay of treatment, but the extent is controversial. Case presentation 82-year-old male, presented with rectal mass in the Emergency Room (ER). After local excision, pathology observed that the mass corresponded to AMM. Despite being stage I (Local disease), a year later it presented with local recurrence and distant metastasis. The patient died 32 months after diagnosis. Conclusions There is no optimal treatment, due to the lack of prospective studies. Wide local excision (WLE) has faster recovery, less post-operatory complications and similar survival rate compared to abdominal perineal resection (APR).
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Nusrath S, Thammineedi SR, Patnaik SC, Raju KVVN, Pawar S, Goel V, Chavali RN, Murthy S. Anorectal Malignant Melanoma-Defining the Optimal Surgical Treatment and Prognostic Factors. Indian J Surg Oncol. 2018;9:519-523. [PMID: 30538382 DOI: 10.1007/s13193-018-0791-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 07/13/2018] [Indexed: 12/18/2022] Open
Abstract
Patients with anorectal malignant melanoma (ARMM) have a poor prognosis. Optimal surgical treatment is not defined. The aim of the study was to define the surgical treatment for ARMM, to compare the overall survival (OS) of abdomino-perineal resection (APR) and wide local excision (WLE) and to study various prognostic factors. Thirty patients of ARMM were managed, 20 with locoregional disease, 10 metastatic. Of the 20 patients with locoregional disease, 15 underwent APR and 5 WLE. The 1-, 2-, 3-, and 4-year overall survival rates (by Kaplan-Meier survival analysis) in the APR group were 67, 40, 40, and 32%, and in WLE group were 100, 100, 67, and 67% respectively. Median survival for APR and WLE groups were 13 and 36 months and were not significant (p 0.48). Node-negative patients had better survival than node positive in the APR group (56 vs. 13 months) (p 0.017). Patients with tumor size < 2cm, lymphovascular invasion and perineural invasion negative, and margin-negative and with superficial infiltration had a trend toward better survival than their counterparts. WLE gives an equivalent oncological outcome and can be offered for patients with smaller ARMM and APR for locally advanced, larger tumors or as a salvage following recurrence after WLE.
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Ohta R, Inoue T, Goto M, Tachimori Y, Sekikawa K. Combined laparoscopic abdomino-endoscopic perineal total mesorectal excision for anorectal malignant melanoma: A case report. Int J Surg Case Rep 2018; 44:135-138. [PMID: 29501018 PMCID: PMC5910508 DOI: 10.1016/j.ijscr.2018.02.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Revised: 01/21/2018] [Accepted: 02/17/2018] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION This report presents a case of anorectal malignant melanoma treated with combined laparoscopic abdomino-endoscopic perineal total mesorectal excision. PRESENTATION OF CASE An 82-year-old female presented with hematochezia. Colonoscopy revealed a 5-cm tumor in the anorectal junction, and biopsy specimen showed malignant melanoma. Modified ransanal total mesorectal excision was performed to get the sufficient surgical resection margins. After lymph node dissection in usual manner, mobilizing the rectum to the level of levator ani muscle. Then a skin incision was made around the anus and the transperineal access platform was placed. The fat tissue of the ischioanal fossa was divided until the levator ani muscle was exposed. The oral side of the colon was transected and specimen was extracted through the perineal incision site. Then stoma was placed laparoscopically. DISCUSSION This procedure provides not only better exposure of the extralevator surgical field, but also efficient resection margins compared with the conventional andominoperineal resection. CONCLUSION To the best of our knowledge, this is the first report of combined laparoscopic abdomino-endoscopic perineal total mesorectal excision for anorectal malignant melanoma. Our experience showed safety and feasible option for anorectal malignant diseases.
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Affiliation(s)
- Ryo Ohta
- Department of Surgery, Institute of Gastroenterology, Kawasaki Saiwai Hospital, Kawasaki, Japan.
| | - Takahiro Inoue
- Department of Surgery, Institute of Gastroenterology, Kawasaki Saiwai Hospital, Kawasaki, Japan
| | - Manabu Goto
- Department of Surgery, Institute of Gastroenterology, Kawasaki Saiwai Hospital, Kawasaki, Japan
| | - Yuji Tachimori
- Department of Surgery, Institute of Gastroenterology, Kawasaki Saiwai Hospital, Kawasaki, Japan
| | - Koji Sekikawa
- Department of Surgery, Institute of Gastroenterology, Kawasaki Saiwai Hospital, Kawasaki, Japan
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Kong X, Liu Q, Lin G, Zhao D, Qiu H, Cui Q. The first attempt in local excision of anorectal malignant melanoma using transanal endoscopic microsurgery. Int J Clin Exp Pathol 2015; 8:11735-11740. [PMID: 26617919 PMCID: PMC4637735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 08/20/2015] [Indexed: 06/05/2023]
Abstract
Anorectal malignant melanoma (AMM) is an uncommon malignancy that is thought to arise from melanocytes in the mucosa around the anorectal junction. AMM is commonly misdiagnosed, and definitive preoperative diagnosis is often difficult. The prognosis of AMM is relatively poor. Although radical resection is required for AMM, there is still no consensus at this moment on which surgical approach is preferred. We herein report a rare case of AMM which was treated by transanal endoscopic microsurgery (TEM) in combination with radiotherapy, which resulted in complete excision of the lesion without complications. The successful treatment for this AMM using TEM emphasizes the need to broaden its application in the treatment of various rectal lesions while preserving organ function and decreasing recurrence.
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Affiliation(s)
- Xiangyi Kong
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical SciencesNo. 1 Shuaifuyuan Hutong of Dongcheng District, Beijing 100730, P. R. China
| | - Qi Liu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical SciencesNo. 1 Shuaifuyuan Hutong of Dongcheng District, Beijing 100730, P. R. China
| | - Guole Lin
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical SciencesNo. 1 Shuaifuyuan Hutong of Dongcheng District, Beijing 100730, P. R. China
| | - Dachun Zhao
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical SciencesNo. 1 Shuaifuyuan Hutong of Dongcheng District, Beijing 100730, P. R. China
| | - Huizhong Qiu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical SciencesNo. 1 Shuaifuyuan Hutong of Dongcheng District, Beijing 100730, P. R. China
| | - Quancai Cui
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical SciencesNo. 1 Shuaifuyuan Hutong of Dongcheng District, Beijing 100730, P. R. China
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Deng CL, Zhou SR, Xie M, Zou WJ, Xu H. Anorectal malignant melanoma: Analysis of 25 cases. Shijie Huaren Xiaohua Zazhi 2014; 22:2645-2649. [DOI: 10.11569/wcjd.v22.i18.2645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the clinical features, diagnosis, treatment and prognosis of anorectal malignant melanoma (ARMM).
METHODS: Clinical records of 25 patients diagnosed with ARMM between January 2000 and August 2010 were reviewed, and the major clinical features, treatment modalities and outcomes were analyzed.
RESULTS: ARMM was associated with a high misdiagnosis rate because of nonspecific symptoms, and of all the patients, 18 (72%) were misdiagnosed with polyposis or haemorrhoids at other hospitals. Pathologic examination and specific immunohistochemical markers HMB45, S-100, and Vimentin were helpful in the differential diagnosis of ARMM. The 1- and 3-year survival rates were 52% and 20%, respectively. The survival was related to clinical stage and the depth of invasion (P < 0.05), but not with sex, age, tumor size, operation mode or chemotherapy (P > 0.05).
CONCLUSION: The primary treatment for rectal ARMM is surgery, and the type of treatment is not correlated with survival. Clinical stage and the depth of invasion are the main factors affecting survival. Early diagnosis and treatment are crucial to improve the prognosis of these patients.
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