Malignant melanoma of the anorectum A report of three cases.

概要

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Three cases of anorectal malignant mealnoma were reported. There were difficulties in making correct preoperative diagnosis. In two of the three cases malignant melanoma was not suspected from the findings of digital examination or proctoscopy. Of the two cases in which preoperative biopsy was taken, one was reported as signet ring cell carcinoma and the other as poorly differentiated adenocarcinoma, showing the difficulty in histological diagnosis of biopsy specimen. In all of those three cases rectal excision (Miles'. operation) was performed. In none of those cases dissection of the inguinal lymphnodes was performed. In two cases adjuvant immuno-chemotherapy using OK- 432 and DTIC, ACNU, Vincristine (DAV therapy) was performed, which was not effective. In the other case BCG therapy was performed which was not effective as well. All the three cases died with wide spread lympatic and blood born metastasis from 8 to 29 months after the initial operation. Reviewing the 126 reported cases in Japan, at present, Miles' operation with adjuvant DAV therapy was considered to be a standard treatment for this disease.
日本大腸肛門病学会の論文