直腸こう門部ｃ‐ｋｉｔ陽性無色素性悪性黒色腫の１例

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  • A CASE OF ANORECTAL c-kit POSITIVE AMELANOTIC MELANOMA

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We report a case of anorectal amelanotic malignant melanoma which stained positive for c-kit.<br> A 79-year-old woman was admitted to our hospital because of anal bleeding at defecation in October 2004. During digital examination of the rectum, a large soft tumor about 5cm in diameter was palpated. Barium enema showed a filling defect in the lower rectum. Abdominal CT scan showed an isodensity mass at the left wall of the rectum. Colonoscopy showed a quarter-circled type 1 tumor. Grossly no pigmentation of the tumor was recognized, and pathological examination of the biopsy specimen indicated a diagnosis of poorly differentiated adenocarcinoma. Abdominoperineal resection was performed with the preoperative diagnosis of rectal carcinoma in December 2004. Microscopically, the tumor cells reacted positively to immunohistological staining with HMB-45 and S-100. Melanin pigment was seen after Fontana-Masson staining in only a few tumor cells. The final pathological diagnosis was amelanotic malignant melanoma.<br> Amelanotic malignant melanoma is a rare entity and has a poor prognosis. We should recognize this disease as a differential diagnosis for interstitial tumors. We must keep in mind as well that the c-kit staining is not specific for GIST and can give positive reactions to melanoma and other disease.

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