Melanoma analdiagnóstico infrecuente en la patología anorrectal

  1. P. Dabán-López 1
  2. T. Gallart-Aragón 1
  3. C. Pérez-Gómez 1
  4. E. Dabán-Collado 1
  5. B. Mirón-Pozo 1
  1. 1 Hospital Clínico Universitario San Cecilio. Granada.
Revista:
Cirugía Andaluza

ISSN: 2695-3811,  1130-3212

Ano de publicación: 2018

Volume: 29

Número: 4

Páxinas: 537-540

Tipo: Artigo

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Outras publicacións en: Cirugía Andaluza

Resumo

Introduction: incidence of anorectal localization of melanoma does not exceed 2% of all melanoma cases. Prognosis of this anorectal pathology, frequently underdiagnosed or diagnosed with remarkable delay, is very poor and depends to a large extent on local -and regional- stage and distant metastasis. Clinic case: a 31-year-old woman was first attended to in Urgent Care for a rectal bleeding episode, which was diagnosed and treated like a hemorrhoid crisis. Due to the persistence of these symptoms, this patient was received again in our hospital and a general surgeon assessed her, certifying a pigmented perianal lesion. Once the study was completed, anatomopathological diagnosis concluded that it was an anal melanoma with a negative extension study. In collaboration with Dermatology and Medical Oncology services, local excision and selective lymph node biopsy were carried out, with negative results. The patient is being treated with interferon, with reviews every six months. Conclusions and discussion: due to the low incidence of anorectal melanoma, prognostic factors have not yet been defined and conclusions differ between study groups. All agree, though, that surgery is the standard treatment in cases of anorectal melanoma, improving the prognosis for patients without distant metastasis. Currently, the conflict concerns whether to undergo a conservative surgery with subsequent monitoring and eventual rescue surgery, or to opt for a more radical surgery at the outset. According to the reviewed articles, the type of surgery does not affect overall survival, but local excision appears preferred by the scientific community.

Referencias bibliográficas

  • Chen H, Cai Y, Liu Y et al (2016) Incidence, surgical treatment, and prognosis of anorectal melanoma from 1973 to 2011: a population-based SEER analysis. Medicine 95:e2770. doi:10.1097/MD.0000000000002770
  • Choi BM, Kim HR, Yun H-R et al (2011) Treatment outcomes of anorectal melanoma. J Korean Soc Coloproctol 27:27– doi:10.3393/jksc.2011.27.1.27
  • Iddings DM, Fleisig AJ, Chen SL, et al. Practice patterns and outcomes for anorectal melanoma in the USA, reviewing three decades of treatment: is more extensive surgical resection beneficial in all patients? Ann Surg Oncol. 2010;17:40–44.
  • Matsuda A, Miyashita M, Matsumoto S, Takahashi G, Matsutani T, Yamada T, Kishi T, Uchida E. Abdominoperineal resection provides better local control but equivalent overall survival to local excision of anorectal malignant melanoma: a systematic review. Ann Surg. 2015 Apr;261(4):670-7.
  • Glowka, T.R., Keyver-Paik, M.D., Thiesler, T. et al. Das anorektale maligne Melanom. Chirurg (2016) 87: 768. https://doi.org/10.1007/s00104-016-0242-x
  • Perez DR, Trakarnsanga A, Shia J, et al. Locoregional lymphadenectomy in the surgical management of anorectal melanoma. Ann Surg Oncol. 2013;20:2339– 2344.
  • Howlader NNA, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975–2012. Bethesda, MD: National Cancer Institute. Available at: http://seercancergov/csr/1975_2012/, based on November 2014 SEER data submission, posted to the SEER website. April 2015.
  • Belli F, Gallino GF, Vullo SL, et al. Melanoma of the anorectal region: the experience of the National Cancer Institute of Milano. Eur J Surg Oncol. 2009;35:757–762
  • Meguerditchian A-N, Meterissian SH, Dunn KB. Anorectal melanoma: diagnosis and treatment. Dis Colon Rectum. 2011;54:638–644.
Fonte de datos: Dialnet