항문직장의 악성흑색종

Abstract

P urpose: Anorectal melanoma is an uncommon tumor that comprises less than 1% of all malignancies of the anorectum.¹Its epidemiologic features, and clinical characteristics have not been well studied. We reviewed our experience in management of malignant melanoma of anorectal region. M ethods: Eight patients with malignant melanoma of anorectal region were treated at Seoul National University Hospital in the period of 1980∼2001. They represented 0.36% of the 2,246 patients with colorectal cancer seen at Seoul National University Hospital during the same period. R esults: Five patients were female. The median age was 60 years. Common presenting symptoms were decreased stool caliber (63%), and anal bleeding (50%). All lesions developed at the area between 2cm and 7cm from anal verge and could be palpated on digital rectal examination. Two patients had multiple hepatic metastases at initial presentation. Of the remaining 6, abdominoperineal resection was performed for 4 patients, and local excision for 2. During the follow-up period with median length of 11 months, local recurrence occurred in 1 patient and distant metastases occurred in 3. Metastatic disease involved lung and/or brain. Five patients died during the follow-up period and the length of mean survival was 12 months. C onclusion: Malignant melanoma of anorectum seems to have a poor prognosis with an appreciable incidence of regional node metastases. Common symptoms were similar to those of common anorectal disease. But all lesions were palpable on digital rectal examination. Increased awareness of this rare condition may lead to early detection and therefore to improved results.