[Malignant melanoma of the anal canal. Apropos of 8 patients and review of the literature].
The authors present 8 patients with malignant melanoma of the anal canal. By including these patients with those already reported in the literature, they systematically analyse the various aspects of this exceptional site. These tumors always develop at the pectinate line and transitional mucosa, while rectal localizations corresponds to contiguous extension from a melanoma of the anal canal. The clinical features are only suggestive when the lesions appear pigmented macroscopically. The histological certainty depends of the demonstration of melanin pigment and is simple when the tumor is pigmented (75% of cases). The diagnostic is more complex in the case of nonpigmented tumors, but is facilitated by electronic microscopy and certain immune markers (Proteins S 100). The constantly very severe prognosis depends of the depth of invasion, frequently assessed by Breslow's method, and lymph node invasion and metastatic spread are very frequent (88% of patients) either at the time of diagnosis or later in the course of the disease. The mean survival of 24 months does not appear to be influenced by treatment which is always surgical, either local excision of abdomino-perineal resection. Abdomino-perineal resection may be preferred in the case of a very small tumor less than 2 mm thick in the absence of any visceral metastases. Radiotherapy to extensive tumors is only palliative treatment and chemotherapy has not been found to be effective to date.
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Service de Colo-Proctologie, Collège de Médecine des Hôpitaux de Paris.
Debou
J M
JM
D000368:Aged; D000671:Amputation, Surgical / Q000379:methods; D001005:Anus Neoplasms / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000601:surgery; D008875:Middle Aged; D011379:Prognosis; D012004:Rectal Neoplasms / Q000175:diagnosis* / Q000601:surgery; D016019:Survival Analysis
Les mélanomes malins du canal anal. A propos de 8 patients et revue de la littérature.