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Please use this identifier to cite or link to this item: http://hdl.handle.net/20.500.12001/3241

 
Title :[症例報告]Primary amelanotic melanoma of the anorectum : A case report and literature review
Authors :Miyazato, Hiroshi
Yamada, Mamoru
Tamai, Osamu
Matsumoto, Mitsuyuki
Shiraishi, Masayuki
Kusano, Toshiomi
Muto, Yoshihiro
Kiyuna, Masaya
Toda, Takayoshi
Nakasone, Katsu
Authors affiliation :First Department of Surgery, Faculty of Medicine, University of the Ryukyus Okinawa, Japan
Department of Clinical Laboratory Medicine, Faculty of Medicine, University of the Ryukyus Okinawa, Japan
Issue Date :1995
Publisher :琉球医学会
Type Local :雑誌掲載論文
Type (NII) :Journal Article
ISSN :1346888X
0289-1530
Abstract :A case of anorectal amelanotic melanoma in a 72-year-old female is reported. The patient presented with several episodes of anal bleeding after defecation. Endoscopic examination showed a 1 cm-polypoid tumor with a roughly irregular surface in the right wall of the anorectum about 5 cm from the anal verge. No pigmentation was evident in the tumor. Endoscopic ultrasonography (EUS) revealed the depth of invasion to be limited to the submucosa. Although poorly differentiated adenocarcinoma was suspected by biopsy, it was difficult to classify the tumor as malignant lymphoma or malignant melanoma. Transanal simple excision of the tumor was performed. The tumor appeared homogeneously gray-whitish and was 10x17 mm in size. The tumor was finally diagnosed to be amelanotic melanoma by electron microscopy and immunohistochemistry. The depth of invasion was limited to the submucosa. The tumor was resected with 1 cm-free margins. A few decades ago, abdominoperineal resection combined with or without pelvic and bilateral inguinal lymph node dissection was recommended for the patients who had anorectal malignant melanoma with no distant metastases. However, recent studies have demonstrated that overall survival is related to the tumor size and staging of the depth of invasion, but not the extent of surgical margins. So we didn't perform additional resection. She is now living and well 11 months after operation with no evidence of recurrence of the disease. She comes to the hospital every three months.
Rights :琉球医学会
URI :http://hdl.handle.net/20.500.12001/3241
Citation :琉球医学会誌 = Ryukyu Medical Journal Vol.15 no.3 p.147 -151
Appears in Collections:Ryukyu Medical Journal

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