Abstract
Anal malignant melanomas are relatively rare tumors. Because of their polypoid structure, they can be confused with benign anorectal diseases. Wide excision and lymph node dissection is recommended especially in melanomas including lymph node metastasis because it reduces local recurrence. We performed abdominoperineal resection + bilateral inguinal + bilateral iliac + paraaortic lymph node dissection in our 77-year-old female patient with the diagnosis of anal malignant melanoma as a result of colonoscopic biopsy performed on the polypoid mass in the anal canal. Since 2 lymph nodes located outside the pararectal fascia persisted in postoperative MRI, we performed lymph node excision with a posterior approach. And the pathology result of the excision performed in this second session was found to be compatible with metastasis. Lymph node dissections are beneficial in terms of local recurrence and survival, especially in patients with anal malignant melanoma with lymph node metastases.
References
- Singer, M. and M.G. Mutch, Anal melanoma. Clinics in colon and Rectal Surgery, 2006. 19(02): p. 078-087.
- Brady, M.S., J.P. Kavolius, and S.H. Quan, Anorectal melanoma. Diseases of the colon & rectum, 1995. 38(2): p. 146-151.
- Carcoforo, P., et al., Primary anorectal melanoma: an update. Journal of Cancer, 2012. 3: p. 449.
- Kobakova, I., et al., Anorectal melanoma-a histopathological case report and a review of the literature. Folia Med (Plovdiv), 2018. 60: p. 641-646.
- Hillenbrand, A., et al., Anorectal amelanotic melanoma. Colorectal Disease, 2008. 10(6): p. 612-615.
- Longo, W.E., et al., Rare anal canal cancers in the US veteran: patterns of disease and results of treatment. The American surgeon, 1995. 61(6): p. 495-500.
- Meguerditchian, A.-N., S.H. Meterissian, and K.B. Dunn, Anorectal melanoma: diagnosis and treatment. Diseases of the colon & rectum, 2011. 54(5): p. 638-644.
- Jutten, E., et al., Surgical treatment of anorectal melanoma: a systematic review and meta-analysis. BJS open, 2021. 5(6): p. zrab107.
- Mireia, M.R. and C.S. Carlos, Anal Melanoma: A Rare Perianal Tumor With a Poor Prognosis. Diseases of the Colon & Rectum, 2020. 63(5): p. 573-576.
Abstract
Anal malign melanomlar görece nadir tümörlerdir. Sıklıkla polipoid yapıda olmaları nedeniyle benign anorektal hastalıklarla karışabilmektedir. Özellikle lenf nodu metastazını içeren melanomlarda geniş eksizyon ve lenf nodu diseksiyonu lokal nüksü azaltması nedeniyle önerilmektedir. 77 yaşındaki kadın hastamıza anal girimdeki polipoid kitleye yapılan kolonoskopik biyopsi sonucunda gelen anal malign melanoma tanısı ile abdominoperineal rezeksiyon + bilateral inguinal + bilateral iliyak + paraaortik lenf nodu diseksiyonu yapıldı. Pararektal fasyanın dışında yer alan iki adet lenf nodunun da postoperatif MR da sebat etmesi üzerine posterior yaklaşımla lenf nodu eksizyonu yapıldı ve bu ikinci seansta yapılan eksizyonun patoloji sonucu metastazla uyumlu görüldü. Özellikle lenf nodu metastazı olan anal malign melanom hastalarında lenf nodu diseksiyonları lokal nüks ve sağkalım açısından faydalıdır.
References
- Singer, M. and M.G. Mutch, Anal melanoma. Clinics in colon and Rectal Surgery, 2006. 19(02): p. 078-087.
- Brady, M.S., J.P. Kavolius, and S.H. Quan, Anorectal melanoma. Diseases of the colon & rectum, 1995. 38(2): p. 146-151.
- Carcoforo, P., et al., Primary anorectal melanoma: an update. Journal of Cancer, 2012. 3: p. 449.
- Kobakova, I., et al., Anorectal melanoma-a histopathological case report and a review of the literature. Folia Med (Plovdiv), 2018. 60: p. 641-646.
- Hillenbrand, A., et al., Anorectal amelanotic melanoma. Colorectal Disease, 2008. 10(6): p. 612-615.
- Longo, W.E., et al., Rare anal canal cancers in the US veteran: patterns of disease and results of treatment. The American surgeon, 1995. 61(6): p. 495-500.
- Meguerditchian, A.-N., S.H. Meterissian, and K.B. Dunn, Anorectal melanoma: diagnosis and treatment. Diseases of the colon & rectum, 2011. 54(5): p. 638-644.
- Jutten, E., et al., Surgical treatment of anorectal melanoma: a systematic review and meta-analysis. BJS open, 2021. 5(6): p. zrab107.
- Mireia, M.R. and C.S. Carlos, Anal Melanoma: A Rare Perianal Tumor With a Poor Prognosis. Diseases of the Colon & Rectum, 2020. 63(5): p. 573-576.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Case Report |
| Authors | |
| Early Pub Date | April 24, 2023 |
| Publication Date | April 28, 2023 |
| Submission Date | January 3, 2023 |
| Published in Issue | Year 2023 Volume: 12 Issue: 1 |
