anorectal malignant melanoma
Introduction
Introduction to anorectal malignant melanoma Malignant melanoma occurs in the skin, eyes, anal canal is the third place, it is generally believed that the tumor comes from the melanocytes of the junction, most of which can produce melanin, a few can not produce, but the cancer is still dopa negative reaction, both The prognosis is basically the same. The tumor grows rapidly, has a high degree of malignancy, early metastasis, and has a very poor prognosis. basic knowledge The proportion of sickness: 0.00001% Susceptible people: no specific population Mode of infection: non-infectious Complications: intestinal obstruction
Cause
Anorectal malignant melanoma etiology
(1) Causes of the disease
Currently there are no related content description.
(two) pathogenesis
The disease is derived from the malignant transformation of melanocytes. The melanocytes or their mother cells are derived from the ectodermal neural crest cells, which migrate to the skin, eye, mucosal surface and nervous system during embryonic development, and are affected by certain factors. Under the circumstance, such as hormonal metabolic disorders, chemical stimulation and high-energy radiation damage, melanocytes hyperplasia and malignant transformation, it is believed that the anorectal junction is a stratified squamous epithelium, a large number of melanocytes, which is anorectal melanoma. The histological basis of the occurrence, therefore, it is currently considered that the resident malignant melanoma is primary, but for the primary malignant melanoma is primary or secondary, there are still differences, most of the rectal malignant melanoma is anal canal The result of the upward expansion of melanocytes after malignant transformation should be regarded as metastasis. The characteristics under the microscope are mainly: tumor cells resemble sputum cells, which are polygonal, fusiform or polygonal, nuclear, deformed, vesicular, nucleoli distinct, division The image phase is indefinite, the cytoplasm is generally less, and most of the melanin particles can be found.
In the early stage of the disease, distant metastasis can occur. The blood transfer is the main mode of metastasis. It can also be metastasized by lymphatic metastasis and metastasis to distant organs. For example, in 72 cases of domestic comprehensive data, 46 cases of metastasis were found at the time of diagnosis. Accounted for 63.9%, including 10 cases of liver, 6 cases of spleen, 23 cases of intra-abdominal lymph nodes, 3 cases of skin soft tissue, 1 case of brain, 3 cases of vaginal invasion.
Prevention
Anorectal malignant melanoma prevention
prevention:
1. For the pigmented nevus that occurs in the easily rubbed area, biopsy should be taken. If the child's big hairs are at the waist, they are often rubbed and squeezed by the belt, and should be removed as soon as possible. If it is difficult to remove all of them at a time, the main part can be removed as much as possible in the middle of the big hairs before the malignant transformation, and the two sides are sutured. After the surrounding skin is loosened, the rest will be removed until all the black sputum is removed to prevent malignant transformation. Specimens must be sent for each resected specimen. If there is malignant transformation, all should be removed and skin grafting should be performed.
2. It is not advisable to stimulate black mites with corrosive drugs or thorough freezing. It is dangerous to repeat it several times without freezing, because black mites often become malignant due to traumatic stimulation. According to reports, some people have become malignant due to incomplete freezing. About 30% to 50% of malignant melanoma is associated with external stimuli. If you need to remove the sputum for cosmetic purposes, it is safe and reliable. Freezing combined with resection, and strive to complete once, should not be divided and resected, the excised specimen should be sent for pathological examination.
3. Colorless information
(1) The color of the color is increased, and the pigment is deep or light.
(2) The color enamel spreads radially to the periphery.
(3) There is no pain or discomfort in the color, and there is a small amount of exudate on the surface.
(4) The lymph nodes in the color sputum area are swollen, and blue and black are faintly visible.
(5) The patient dissolves blue and black urine. Health care products query Breakline anorectal malignant melanoma Chinese medicine treatment
There is no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease.
Complication
Anorectal malignant melanoma complications Complications, intestinal obstruction
1. Colon obstruction: It is one of the late complications of anorectal malignant melanoma, which can occur suddenly or gradually. Mostly caused by tumor hyperplasia obstruction of the intestine or intestinal lumen constriction, but also due to acute inflammation, congestion, edema, hemorrhage, etc. in the tumor.
2. Intestinal perforation: There are two cases of anal canal malignant melanoma complicated with perforation: perforation occurs in the local part of the cancer; proximal colon perforation is a complication of cancer obstruction. After perforation, clinical manifestations of diffuse peritonitis, localized peritonitis or local abscess formation. Diffuse peritonitis is often accompanied by toxic shock, and the mortality rate is extremely high.
Symptom
Anorectal malignant melanoma symptoms Common symptoms Anal pain constipation Blood diarrhea Anus has a black mass prolapse
1. Prolapse symptoms: There are black lumps in the anus, which are small in the early stage, and can be repaid by themselves. Afterwards, they need to be retracted by hand.
2. Blood in the stool: The tumor is in a low position, which is susceptible to bleeding due to fecal friction or trauma, mostly blood, or black discharge, stench.
3. Anal canal stimulation symptoms: As the tumor protrudes into the rectum of the rectum, stimulating the receptors of the rectal wall, the patient often feels anal discomfort discomfort, changes in bowel habits, constipation and diarrhea alternate.
4. Lump: generally 3 ~ 6cm, near the tooth line, nodular, polypoid, hard, mostly purple black or brownish black.
5. Anal pain: It is a common symptom of malignant melanoma. When the tumor collapses, infects or invades the tissues around the anus, it can cause anal pain.
Rectal melanoma is generally seen in the eyes of 80% or less. It is common to have melanoma with little or no melanin, so it is often misdiagnosed. The final diagnosis often requires pathological examination. Because the skin around the anus is often bordered by sputum, the volume of sputum More than 0.5cm should be highly suspected of this disease, for no pigmented tumors (1/3), can also be confirmed by Massobn-Fonlana melanin silver staining or dopa staining, tyrosinase reaction.
Examine
Examination of anorectal malignant melanoma
Histopathological examination is the main basis for diagnosis. Because melanin is very small or is a pigment-free melanoma, the entire tumor should be removed when taking the material. It is not appropriate to take a biopsy to avoid iatrogenic spread and low biopsy rate. Non-pigmented melanoma can be assisted by pathological diagnosis using Massobn-Fonlana melanin silver staining or dopa staining, tyrosinase reaction, and the like.
The anal speculum examination showed a purple-black or brown-black protruding mass near the dentate line, generally 3 to 6 cm. The shape was like an umbrella, and it was short and wide, or nodular, like cauliflower.
Diagnosis
Diagnosis and diagnosis of anorectal malignant melanoma
It should be differentiated from prolapsed hernia, thrombotic external hemorrhoids, polyp hemorrhagic necrosis and rectal cancer.
