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目的:探讨肛管直肠恶性黑色素瘤的误诊原因及预防。方法:回顾性分析17例肛管直肠恶性黑色素瘤误诊患者的临床资料。结果:临床表现为便血9例(52.9%),肛门肿物6例(35.3%),大便性状改变1例(5.9%),肛门下坠感或疼痛1例(5.9%)。误诊为痔6例(35.3%),息肉7例(41.2%),直肠癌4例(23.5%)。结论:肛管直肠恶性黑色素瘤少见易误诊,预后差,便血是最常见的症状,免疫组化有助确诊。
Objective: To investigate the causes and prevention of misdiagnosis of anorectal malignant melanoma. Methods: The clinical data of 17 patients with misdiagnosed anorectal malignant melanoma were analyzed retrospectively. Results: The clinical manifestations included blood stasis in 9 patients (52.9%), anus in 6 patients (35.3%), stool changes in 1 patient (5.9%), anal soreness or pain in 1 patient (5.9%). 6 cases were misdiagnosed as hemorrhoids (35.3%), 7 cases (41.2%) were polyps, and 4 cases (23.5%) were rectal cancer. Conclusions: Anal canal malignant melanoma is rare and easily misdiagnosed. The prognosis is poor. Blood in the stool is the most common symptom. Immunohistochemistry is helpful for diagnosis.