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A Journal on Surgery

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Chirurgia 1999 December;12(6):437-9

language: Italian

On a rare case of synchronous anorectal melanoma and rectal adenocarcinoma

Pandolfo N., Arezzo A., Scajola P., Ciciliot M., Milone L.

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The authors present a case of synchronous rectal adenocarcinoma and anorectal melanoma, the first to be described, recently observed in a 75 year-old female, who underwent a wide abdominoperineal palliative resection. At diagnosis, infact, the patient showed already metastases to inguinal nodes, lungs and adrenal glands. Histopathological examination of the specimen showed two different neoplastic entities, consisting of a proximal rectal adenocarcinoma and a distal anorectal malignant melanoma, pigmented, with a prevalence of epithelioid cells. There was a clear impact between the two neoplasms, although no compenetration was evident. Right inguinal lymph nodes, fused, as well as 4 lymph nodes resected from the perirectal tissue were positive for metastases from malignant melanoma. No lymph node was found positive for metastases from adenocarcinoma. The postoperative course was complicated by an ulcer perforation which required a second intervention and later two episodes of subarachonid hemorrhage, determined a decline of general condition of the patient preventing any adiuvant therapy. The patient died 13 months after surgery for scattered disease. The rarity of this pathological finding and the different treatment options offered, on the basis of the more recent literature, are discussed.

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