Purpose
To retrospectively evaluate CT findings and clinicopathologic features in patients with pathologically proved anorectal melanoma.
To discuss the diagnosis and treatment modalities of this entity.
Methods and Materials
Patient selection
This retrospective study was approved by our hospital's institutional review board,
and the requirement for informed consent was waived.
We reviewed a series of 10 cases in our hospital between Jan 2006 and Feb 2012.
Patients with histopathologic confirmed anorectal melanoma who had undergone material-enhanced CT prior to surgery were included.These included4 male and 6 female (mean age:61 years; age range,41-75 years).
CT technique
10patients were performed CT by using the Toshiba Aquillion 64-MDCT scanner.
They underwent abdomen-pelvic scan.
A bolus of nonionic...
Results
Symtoms
The most common presentation was rectal bleeding(n=8),followed by tenesmus(n=5) and Dyschezia (n=3) .
CT fingdings
Mean length of the tumors: 3.1cm(range,1.9~7.7cm); Mean diameter:2.5cm(range,1~7cm).
Morphology:All of the tumors appeared as polypoid or fungating intraluminal neoplasm(Figure1,3).Peritectal infiltration could be observed in 5 cases.
(Figure1,2,3).
Perirectal infiltration could extended to the presacral space (n=2).
3 patients had lymphadenopathy,
involving the perirectal(Figure1),
presacral(Figure3) and iliac vessel lymph node stations.
Distant metastasis was noted in 2 patients(Figure3).
There was no evidence of obstruction in any patients.
Treatment
6 underwent...
Conclusion
On CT scans,
anorectal melanoma appeared as intraluminal fungating masses,
expanding the lumen without causing obstruction,
with perirectal infiltration and lymphadenopathy.
The preoperative staging has an important role in influencing treatment decisions and abdominoperineal resection may be considered as the first choice for the anorectal melanoma patients without distant metastasis.
References
1.J Zhong,
JN Liu et al,
Diagnosis and treatment of anorectal malignant melanoma- a report of 22 cases with literature review.
Chinese Journal of Cancer 2006,25 (5):619-624.
2.C Olinici,
Ioana Muntean et al,
Anorectal melanoma.
Case report and review of the literature.
Romanian Journal of Morphology and Embryology 2007,48(3):299-302.
3.Berna Aytac,
Saduman Adim et al.
Anorectal malignant melanomas: Experience of Uludag University.
Kaohsing Journal Med Sci 2010,26(12):658-662.
4.Marc Singer,
Matthew Mutch,
Anal melanoma.
Clinical colon rectal surg 2006,19(78-87).
5.Kyoung W.K,
Hyun K.H et al.
Primary...
Personal Information
Xuanzi Chengqian MD.
Diagnostic Imaging Department,
Cancer Institute& Hospital.
Chinese Academy of Medical Sciences,
Peking Union Medical College,100021,
Beijing,
China