A Case of Primary Malignant Melanoma of the Sigmoid Colon: A Case Report and Review of 15 Cases

症例は49歳の女性で，血便を主訴に来院した．下部消化管内視鏡にてS状結腸に1型の暗黒色の腫瘤を認め，皮膚や他臓器からの転移所見はなく，組織学的にS状結腸原発の悪性黒色腫（pSS，pN2，cH0，cM0，pP0；fStage IIIb）と診断した．術後5か月でリンパ節再発が見られdacarbazine（DTIC)・nimustine（ACNU)・cisplatin・tamoxifenの多剤併用療法（DAC-Tam）を施行するも，乳房，脳に転移を来し術後11か月で原癌死した．1938年以降の欧米を含めた結腸原発の悪性黒色腫に関する15例の文献的考察では，本邦症例は欧米に比べて発症年齢に差はなかったが，発症部位は左側結腸に多くみられた．治療は有用な化学療法はなく，直腸肛門部の悪性黒色腫と同様，原病変に対する根治術が有用と考えられるが，結腸の場合報告例が少なく手術治療の成績は不明である．

[1]  T. Akalın,et al.  Colonic malignant melanoma, primary or metastatic? Case report. , 2010, The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology.

[2]  T. Akaraviputh,et al.  Surgery for gastrointestinal malignant melanoma: experience from surgical training center. , 2010, World journal of gastroenterology.

[3]  Y. Sato,et al.  Primary amelanotic malignant melanoma of the colon. , 2010, Endoscopy.

[4]  N. Koide,et al.  Surgical treatment for anorectal malignant melanoma: report of five cases and review of 79 Japanese cases , 2008, International Journal of Colorectal Disease.

[5]  K. Miyazaki,et al.  Primary colonic malignant melanoma , 2006, Pathology international.

[6]  F. McNicol,et al.  Primary malignant melanoma of the colon in an oculocutaneous albino. , 2005, The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland.

[7]  M. Hellinger,et al.  Primary Malignant Melanoma of the Right Colon , 2004, The American surgeon.

[8]  R. Salem,et al.  Colonic melanoma, primary or regressed primary. , 2000, Journal of clinical gastroenterology.

[9]  M. Matsuda,et al.  A Case of Amelanotic Malignant Melanoma of the Sigmoid CoIon , 2000 .

[10]  M. Imamura,et al.  Malignant Melanoma of Anorectum-A Report of Three Cases- , 1993 .

[11]  H. Hara,et al.  A Case Report of Prolonged Survival of Anorectal Melanoma. , 1992 .

[12]  Y. Murayama,et al.  MALIGNANT MELANOMA OF THE COLON AND ANORECTUM , 1983 .