A Rare Metastatic Primary Rectal Melanoma in a Geriatric Male.

Journal of Medical Cases Pub Date : 2022-08-01 Epub Date: 2022-08-19 DOI:10.14740/jmc3929
Onyinye Ugonabo, Mujtaba Mohamed, Ebubechukwu Ezeh, Joseph Simmons, Jonathan Cuda, Shima Ghavimi
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Abstract

Primary rectal melanoma (PRM) is an uncommon malignancy whose etiology remains unknown. Most patients present with rectal bleeding. Distant metastasis is commonly seen in the lung and liver. The incidence rates for locoregional lymph node metastases on initial presentation are almost 60%. Histology and immunochemistry are useful and are the gold standard for diagnosis. The prognosis is very poor due to the late presentation of patients. Optimum surgical treatment remains controversial. Abdominoperineal resection was considered traditionally but over time, has been found to have no survival benefit. Current literature and studies, therefore, recommend wide local excision. The beneficial effects of chemotherapy versus radiotherapy use are still debatable. Herein, we discuss a case of a 72-year-old Caucasian male with rectal bleeding found to have metastasized PRM.

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一例老年男性罕见的转移性原发性直肠黑色素瘤。
原发性直肠黑色素瘤是一种罕见的恶性肿瘤,其病因尚不清楚。大多数患者表现为直肠出血。远处转移常见于肺和肝。初次发病时局部淋巴结转移的发生率约为60%。组织学和免疫化学是有用的,是诊断的金标准。由于患者出现较晚,预后很差。最佳手术治疗仍有争议。传统上认为腹会阴切除术,但随着时间的推移,已经发现没有生存的好处。因此,目前的文献和研究建议广泛局部切除。化疗与放疗的有益效果仍有争议。在此,我们讨论的情况下,一个72岁的白人男性直肠出血发现转移PRM。
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