直腸肛門部悪性黒色腫-自験例と本邦報告例137例の検討-

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We experienced a case of malignant melanoma of the anorectum and reviewed 137 cases previously reported in Japan.<BR>A 47-year-old female was diagnosed as having this disease by cytological examination and abdomino-perineal resection (APR) was performed, followed by adjuvant immuno-chemo-endocrinotherapy (DAVP, oral BCG, interferon-β and Tamoxifen regimen). Twenty-two months after the operation, she died of multiple metastases including the cerebrum.<BR>This disease is relatively rare and has a poor prognosis. We reviewed the clinical course of this disease and the therapy, and were able to summarize our conclusions as follows : 1) Many patients complained of symptoms such as anal bleeding for an average duration of. 11 months. 2) Of the total patients, 47 were male and 86 were female. 3) In 75 of the 135 cases (55 %), the tumor was situated in the transitional zone and 24 of the 104 cases (23 %) had multiple lesions near the transitional zone.<BR>The most important factors in prognosis appear to be the size of the tumor, the depth of invasion and macroscopical findings.<BR>We therefore concluded that it is desirable to discover the disease at an earlier stage, and then perform APR with bilateral groin dissection and continue appropriate adjuvant therapy.
日本大腸肛門病学会の論文