【转移性黑色素瘤致肠套叠1例】。

Chirurgia italiana Pub Date : 2009-03-01
Carmine Ammaturo, Salvatore Pastore, Costantino Cerrato, Massimiliano Santoro, Romualdo Rossi, Flavio Fabozzi, Rossella Brunaccino, Miaria De Nigris, Pietro Paolo Podio, Raffaele De Luca
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引用次数: 0

摘要

虽然胃肠道是黑色素瘤转移的一个相当常见的部位,但由这种情况引起的小肠肠套叠的报道很少。肠道转移的存在是一种已经处于晚期的疾病的表现,因此,这些患者的预后通常很差,只有零星的病例在切除手术后长期存活。我们描述的情况下,病人转介到我们的部门与坦率闭塞的临床图片。术前通过超声和腹部CAT扫描诊断回肠-回肠肠套叠。患者不知道自己患有皮肤黑色素瘤,而且,只有在对手术标本进行组织学检查并随后在背侧皮肤水平上寻找和确定原发病变后,才有可能诊断为转移性黑色素瘤。我们进行了广泛的回肠切除术和端到端肠肠吻合术。手术后10个月患者仍然存活,但由于存在弥漫性肝转移和腹水,总体情况不佳。我们认为根治性切除手术可以有效缓解这些患者的症状,使其症状消失,术后发病率和死亡率最低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Intestinal intussusception due to metastatic melanoma: a case report].

Although the gastrointestinal tract is a fairly frequent site of melanoma metastases, reports of small bowel intussusception caused by this condition are rare. The presence of intestinal metastases is an expression of what is already a disease at an advanced stage and, therefore, the prognosis of these patients is generally poor with only sporadic cases of long-term survival after resective surgery. We describe the case of a patient referred to our department with a clinical picture of frank occlusion. Ileo-ileal intussusception was diagnosed preoperatively thanks to ultrasound and abdominal CAT scans. The patient was unaware that he had a cutaneous melanoma and, moreover, the diagnosis of a metastasised melanoma was possible only after histological examination of the surgical specimen and the subsequent search for and identification of the primary lesion at the level of the dorsal skin. We performed an extensive ileal resection with an end-to-end entero-enteroanastomosis. Ten months after the operation the patient is still alive but in poor general condition due to the presence of diffuse liver metastases and ascites. We believe that radical resective surgery affords valid palliation for these patients, with disappearance of symptoms and minimal postoperative morbidity and mortality.

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