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Treatment Outcomes of Anorectal Melanoma

대한대장항문학회지 2011년 27권 1호 p.27 ~ 30
 ( Choi Byung-Min ) - Sungkyunkwan University School of Medicine Department of Surgery

 ( Kim Hyoung-Ran ) - Sungkyunkwan University School of Medicine Department of Surgery
 ( Choi Seung-Ho ) - Sungkyunkwan University School of Medicine Department of Surgery
 ( Cho Yong-Beom ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
 ( Kim Hee-Cheol ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
 ( Yun Seong-Hyeon ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
 ( Lee Woo-Yong ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
 ( Chun Ho-Kyung ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery

Abstract


Purpose: An anorectal melanoma (AM) is a very rare tumor. However, sufficient data supporting effective surgical options for the disease do not exist. This retrospective review aimed to analyze treatment outcomes for an AM.

Methods: From June 1999 to December 2008, we retrospectively reviewed a prospectively collected consecutive series of 19 patients who had undergone a surgical resection for an AM at a single institute. Surgical method and clinicopathological factors were analyzed.

Results: The median age was 61.4 years (range, 46 to79 years). Main symptoms were an anal mass, hematochezia, perianal pain, tenesmus, fecal incontinence, and bowel habit change. The average duration of symptoms before diagnosis was 7.8 months (range, 1 to 36 months). S-100 and HMB-45 were positive in all patients, even in non-melanin pigmentation. There were 12 abdominoperineal resections (APRs) and 7 wide local excisions (WEs). The APR showed longer overall survival when compared with the WE (64.1 months vs. 10.9 months, P < 0.001). No patients who underwent a WE survived more than 13 months.

Conclusion: A high index of suspicion is necessary to establish the diagnosis for an AM in patients with anal symptoms, and S-100 and HMB-45 can be useful markers for an AM. Even with the small number of cases and the short follow-up, our data suggest that an APR for an AM may provide longer survival than a WE.

키워드

Anorectal melanoma; Wide excision;Abdominoperineal resection; Immunohistochemical markers
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