Primer Anorektal Malign Melanom: 5 Yıllık Tek Merkez Deneyimi Türkçe

Abstract

Amaç: Gastrointestinal sistemde Malign Melanom beklenmedik bir durumdur fakat nadir değildir. Primer Malign melanom anorektol bölgede nadir görülür. Uzun dönem yaşam beklentisi nadirdir. Çoğu hasta tedavi edilemeyen sistemik hastalık nedeniyle kaybedilmektedir. Bu çalışmada Malign Melanomla ilgili klinik deneyimlerimizi aktararak, tanı ve tedavisi ile ilgili güncel literatür bilgilerini paylaşmayı amaçladık.Materyal ve metot: 2006-2011 tarihleri arasında cerrahi girişimde bulunulan ve patolojik tanısı Malign Melanom olan 10 olgu retrospektif olarak incelendi. Hastalar yaş, cinsiyet, klin görünüm, metastaz varlığı, immünhistokimyasal özelliği, takip süreleri ve uygulanan cerrahi girişimin açısından değerlendirildi.Bulgular: Hastaların 4'ü kadın, 6'si erkek olup yaş ortalaması 67,7 ' idi. Beş hastada cerrahi tedavi ile kür sağlandı. Dört hasta inoperable olarak tespit edildi. Tüm vakalarda S-100 pozitifti. Hastalar ortalama 15 ay takip edildi. Sonuçlar: Primer anorektal malign melanom, anorektal tümörlerin ayırıcı tanısında nadir bir nedendir. Tercih edilen tedavi seçeneği cerrahidir. Palyatif amaçlı kemoterapi ve immünoterapi kullanılır. Tedavi yöntemlerindeki gelişmelere rağmen, bu tümörün prognozu halen kötüdür

Keywords

• Habis melanom,tümörler,rektal,anal kanal,tedavi

Primary Anorectal malignant melanoma: Five years of experience at a single center

Abstract

Background: Malignant melanoma in the gastrointestinal tract is uncommon but not rare. Primary malignant melanoma is a rare entity in the anorectum. Long–term survival is rare, as most patients die of disseminated systemic disease regardless of treatment. In this study we are aiming to share the most up to date knowledge about diagnosis and treatment of these tumors by transferring our clinical experience about malignant melanoma.Methods: The 10 patients who was operated and pathologic examination were reported as malignant melanoma between 2006–2011 years have been viewed retrospectively. Patients' age, sex, clinical, presence of metastasis, survival and immunohistopathologic features and treatment methods were evaluated.Results: Four of patients were women and 6 of them were men whose age averages were 67,7 . With a surgical intervention 5 of them had been cured. 4 cases accepted as an inoperable. S-100 was positive in our all cases. Patients had been observed for 15 months.Conclusions: Primary anorectal malignant melanoma is a rare cause in the differential diagnosis of anorectal tumors. Surgery remains the therapy of choice. Chemotherapy and immunotherapy are principally used in a palliative setting. Despite advances in therapy, the prognosis of this tumor entity remains unfavorable

Keywords

• Malignant melanoma,neoplasms,rectal,anal canal,treatment

References

1. 1) Meguerditchian AN, Meterissian SH, Dunn KB. Anorectal melanoma: diagnosis and treatment. Dis Colon Rectum 2011;54(5):638-44.
2. 2) Damodaran O, Morgan A, Mendelsohn G. Primary malignant melanoma in the anorectum: an uncommon cancer. N Z Med J 2008;121(1270):66-8.
3. 3) Thibault C, Sagar P, Nivatvongs S, et al. Anorectal melanoma-an incurable d i s e a s e ? Di s Co l o n Re c t u m 1997;40(6): 661-8.
4. 4) Li XB, Shi L, Zhang SM. Anorectal malignant melanoma: diagnosis and treatment of 42 cases. Chin J Cancer Res 2010; 22: 176-80.
5. 5) Tavusbay C, Atahan K, Haciyanlı M, et al. Primary Malignant Melanoma of the Rectum: Analysis of 6 Cases and Review of the Literature. Kolon Rektum Hast Derg 2011; 21: 109-15
6. 6) Brady MS, Kavolius JP, Quan SH. Anorectal melanoma. A 64-year experience at Memorial SloanKettering Cancer Center. Dis Colon Rectum 1995;38(2):146-51.
7. 7) Mason JK, Helwig EB. Ano-rectal melanoma. Cancer 1966;19(1):39-50.
8. 8) Moozar KL, Wong CS, Couture J. Anorectal malignant melanoma: treatment with surgery or radiation therapy, or both. Can J Surg 2003;46(5):345-9.

9. 9) Che X, Zhao DB, Wu YK, et al. Anorectal malignant melanomas: retrospective experience with surgical management. World J Gastroenterol 2011;17(4):534- 9.
10. 10) Nicholson AG, Cox PM, Marks CG, Cook MG. Primary mal ignant m e l a n o m a o f t h e r e c t u m . Histopathology 1993;22(3):261-4.
11. 11) Atıcıl AE, Özer İ, Bastoncu EB, Akoğlu M. Surgical Treatment of Anorectal Melanoma. Kolon Rektum Hast Derg 2009;19:146-51
12. 12) Choi BM, Kim HR, Yun HR, et al. Treatment outcomes of anorectal melanoma. J Korean Soc Coloproctol 2011;27(1):27-30.
13. 13) Malik A, Hull T, Floruta C. What is the best surgical treatment for anorectal melanoma? Int J Colorectal Dis 2004;19(2):121-3.
14. 14) Aytac B, Adim SB, Yerci O, et al. Anorectal malignant melanomas: experience of Uludag University. Kaohsiung J Med Sci 2010;26(12):658- 62.
15. 15) 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(7):757-62.
16. 16) Belbaraka R, Elharroudi T, Ismaili N, et al. Management of anorectal melanoma: report of 17cases and literature review. J Gastrointest Cancer. 2012;43(1):31-5.
17. 17) Pessaux P, Pocard M, Elias D, et al. Surgical management of primary anorectal melanoma. British Journal of Surgery 2004;91(9):1183-7.
18. 18) Yap LB, Neary P. A comparison of wide local excision with abdominoperineal resection inanorectal melanoma. Melanoma Res 2004;14(2):147-50.
19. 19) Weyandt GH, Eggert AO, Houf M, et al. Anorec tal melanoma: surgi cal management guidelines according to tumour thickness. Br J Cancer 2003;89(11):2019-22.