Clinical and Imaging Research in the Diagnosis of Anorectal Melanoma with Surgical Outcome: A Case Report and Literature Review

Q4 Medicine Journal of Coloproctology Pub Date : 2023-09-01 DOI:10.1055/s-0043-1774735
Ana Luiza Moraes Rocha, Gabriella Giandotti Gomar, João Pedro Cruz Lima Chagas, Dayara Mussi Salomão, Luciana Clivatti
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Abstract

Abstract Objective This study aims to report the case of a 69-year-old female patient with a diagnosis of anorectal melanoma (AM) established by immunohistochemistry. Methods Clinical case report, a descriptive and qualitative study. Results The patient had a nodular and ulcerative lesion in the anal region, the imaging exams revealed an expansive lesion that affected the rectum and the vaginal wall. The chosen course of treatment was initial surgical intervention, the surgery and postoperative course progressed without complications, and the anatomopathological examination confirmed the diagnosis of invasive malignant melanoma of the distal rectum of anorectal transition. The anatomopathological examination confirmed the diagnosis of invasive malignant melanoma located in the distal rectum of the anorectal transition. Immunohistochemistry analysis showed infiltrative melanoma with microsatellites, as well as peri and intratumoral lymphocytic infiltrate, angiolymphatic invasion, and perineural invasion. The surgical resection margins, ovaries, posterior vaginal wall, and parametrium showed no signs of neoplastic involvement. Following the surgery, the patient began immunotherapy, which she is still undergoing. Conclusions The survival rate of AM can be improved through various diagnostic and therapeutic modalities. However, further exploration of this topic through clinical studies is necessary to enhance both diagnosis and treatment.
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直肠肛管黑色素瘤的临床及影像学研究与手术预后:1例报告及文献复习
摘要目的报告1例69岁女性经免疫组化诊断为肛肠黑色素瘤(AM)的病例。方法采用临床病例报告、定性和描述性研究相结合的方法。结果患者肛门结节性溃疡性病变,影像学检查显示病变扩张性,累及直肠及阴道壁。选择的疗程为初始手术干预,手术及术后病程进展无并发症,解剖病理检查确诊为肛肠过渡直肠远端浸润性恶性黑色素瘤。解剖病理检查证实了位于肛肠过渡直肠远端浸润性恶性黑色素瘤的诊断。免疫组织化学分析显示浸润性黑色素瘤伴微卫星,瘤周和瘤内淋巴细胞浸润,血管淋巴浸润和神经周围浸润。手术切除边缘,卵巢,阴道后壁和参数显示没有肿瘤累及的迹象。手术后,患者开始了免疫治疗,目前仍在接受治疗。结论AM可通过多种诊断和治疗方式提高生存率。然而,有必要通过临床研究进一步探索这一主题,以提高诊断和治疗水平。
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来源期刊
Journal of Coloproctology
Journal of Coloproctology Medicine-Gastroenterology
CiteScore
0.60
自引率
0.00%
发文量
41
审稿时长
47 weeks
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