Rectal malignant melanomas (RMM) are remarkably uncommon, the rectal location represents less than one percent of all rectal cancer. Because of its low global survival rate, the surgical strategy is a subject of controversy for attaining a r0 resection. the palliative treatment is also debateable, but recently; radiotherapy and immunotherapy became the preferred treatment and offer the best outcome. to ensure r0 resection, abdominoperineal resection (apr) is considered the main surgical option, but because of its morbidity and functional limitations, local excision techniques such as endoscopic mucosal resection (emr) combined with chemoradiotherapy are being increasingly performed to preserve the quality of life and reduce local recurrence rate. In this report, we evaluate the place that apr still keeps as surgical procedure in comparison to partial excision. we report a case of a 72 years old patient, who presented rectal syndrome with rectorrhagia for 2 months, the diagnosis of localized rectal melanoma was confirmed by endoscopy, magnetic resonance imaging, histological analysis tissue with immunohistochemistry. the procedure strategy was a surgical treatment with apr. After a long recurrence-free survival period, the patient develops local recurrence and immunotherapy-resistant metastasis.
Cystic lymphangioma is a rare malformative congenital tumor of the lymphatic vessels. It is commonly seen in children and mainly occurs in the head and cervicothoracic region. Abdominal and especially retroperitoneal involvement is rare in adults. This tumor is often asymptomatic but it can be manifested by mass effect with polymorphic symptomatology depending on the location and size. Digestive haemorrhage due to retroperitoneal cystic lymphangioma with posterior duodenopancreatic infiltration in an elderly patient is an exceptional manifestation of a benign tumor. We report a case of retro-duodenopancreatic cystic lymphangioma revealed by gastrointestinal bleeding in a 65 year-old man who was treated by tumor resection with organ preservation. The recovery was complicated by a duodenal fistula with spontaneous dry-up within 17 days, the patient left the hospital in 3 weeks.
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