A Case of Proctogenic Malignant Amelanotic Melanoma.

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A case of proctogenic malignant amelanotic melanoma is reported. The patient, a 73-year-old female, visited our hospital in June of 1988 with a chief complaint of hemorrhage in the anal region. Proctoscoay revealed a polyp having a diameter of about 1.5cm at 12 o'clock 2cm oral from the anal verge. Surface of the polyp was rough and irregular. Transanal polypectomy was performed. The polyp was histopathologically diagnosed to be a poorly diagnosed to be a poorly di erentiated adenocarcinoma with a depth of invasion to the proper muscle abdominoperitoneal resection was rejected by the patient and her family, the lesion-including the scar-was resected again via the anus. However, no residual cancer was found in the specimen.<BR>In April of 1989, the patient was hospitalizied again due to a tumor of the chest wall and backache. On the basis of special staining of the primary rectal lesion specimen and a biopsy specimen of the chest wall tumor, the patient was diagnosed as having malignant melanoma. Before the de nite diagnosis has been obtained, the chest wall metastasis aggravated, and the patient died 341 days after the rrst polyaectomy. Very few cases of proctogenic malignant amelanotic melanoma have been reported. This case shows that it is necessary to be more careful regarding the diagnosis and treatment of this disease.
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