Anorectal melanoma: Clinical case
DOI:
https://doi.org/10.5281/zenodo.10278175Keywords:
Colorectal Surgery, Anus Neoplasms, Hemorrhoidectomy, MelanomaAbstract
Background: Anorectal melanoma (AM) is a rare and aggressive type of tumor, with varied and inconclusive scientific information. Its preoperative diagnosis is challenging due to its rarity and similarity to other anorectal conditions. It represents only 1.3% of melanomas and affects more women than men. Approximately 20-30% of AM cases are amelanotic, complicating endoscopic detection and leading to misdiagnoses. AM is often confused with hemorrhoids, polyps, and rectal cancer in two thirds of patients due to similar symptoms. The causes and risk factors of AM are not well understood, but they are suspected to differ from cutaneous and ocular melanomas. Diagnosis is performed through biopsy and immunohistochemical staining. Colonoscopy helps to characterize the lesions, and histological examination is crucial for definitive diagnosis.
Clinical case: 50-year-old woman with rectal bleeding and proctalgia. AM was diagnosed through colonoscopy, and transanal resection with hemorrhoidectomy was performed.
Conclusions: Management of AM is complicated by the lack of randomized trials. Resection surgery is the standard treatment, but there is no established protocol. Wide local excision may be an option for limited cases. Further research is needed to improve the management and treatment of AM. Early detection and complete surgical removal are crucial for enhancing survival in these patients.
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References
Reina A, Errasti J, Espín E. Anorectal melanoma. An update. Cir Esp. 2014;92(8):510-6.
Hillenbrand A, Barth TF, Henne-Bruns D, et al. Anorectal amelanotic melanoma. Colorectal Dis. 2008;10:612-15.
Zhang S, Gao F, Wan D. Effect of misdiagnosis on the prognosis of anorectal malignant melanoma. J Cancer Res Clin Oncol. 2010;136:1401-5.
Felz MW, Winburn GB, Kallab AM, et al. Anal melanoma: an aggressive malignancy masquerading as hemorrhoids. South Med J. 2001;94:880-5.
Belli F, Gallino GF, Lo Vullo S et al. Melanoma of the anorectal region: the experience of the National Cancer Institute of Milano. Eur J Surg Oncol. 2009;35:757-62.
Weyandt GH, Eggert AO, Houf M, et al. Anorectal melanoma: surgical management guidelines according to tumour thickness. Br J Cancer. 2003;89:2019-22.
Malaguarnera M, Giordano M, Rando A, et al. Intestinal lymphoma: a case report. Eur Rev Med Pharmacol Sci. 2011;15:1347-51.
Nakhleh RE, Wick MR, Rocamora A, et al. Morphologic diversity in malignant melanomas. Am J Clin Pathol. 1990;93:731-40.
Falch C, Stojadinovic A, von Weyhern CH, et al. Anorectal malignant melanoma: Extensive 45-year review and proposal for a novel staging classification. J Am Coll Surg. 2013; 217:324-35.
Row D, Weiser MR. Anorectal melanoma. Clin Colon Rectal Surg. 2009;22(2):120-6. doi: 10.1055/s-0029-1223844.
Mikkelsen LH, Larsen AC, von Buchwald C, et al. Mucosal malignant melanoma - a clinical, oncological, pathological and genetic survey. APMIS. 2016;124:475-86.
Adileh M, Yuval JB, Huang S, et al. Anorectal Mucosal Melanoma in the Era of Immune Checkpoint Inhibition: Should We Change Our Surgical Management Paradigm? Dis Colon Rectum. 2021;64(5):555-62.
Kaya S, Kement M, Altuntas YE, et al. Anal melanoma: outcomes of current surgical approaches. Niger J Clin Pract. 2018;21:1622-6.
Tanaka S, Ohta T, Fujimoto T, et al. Endoscopic mucosal resection of primary anorectal malignant melanoma: a case report. Acta Med Okayama. 2008;62:421-4.
Cacopardo B, Pinzone M, Berretta S, et al. Localized and systemic bacterial infections in necrotizing pancreatitis submitted to surgical necrosectomy or percutaneous drainage of necrotic secretions. BMC Surg. 2013;13:S50.
Slingluff CL Jr, Vollmer RT, Seigler HF. Anorectal melanoma: clinical characteristics and results of surgical management in twenty-four patients. Surgery. 1990;107:1-9.
Buissin D, Sterle A, Schmiegelow P, et al. Primary anorectal malignant melanoma: a rare but aggressive tumor: report of a case. World J Surg Oncol. 2015;13:12.
Kiran RP, Rottoli M, Pokala N, et al. Long-term outcomes after local excision and radical surgery for anal melanoma: data from a population database. Dis Colon Rectum. 2010;53:402-8.
Yeh JJ, Shia J, Hwu WJ, et al. The role of abdominoperineal resection as surgical therapy for anorectal melanoma. Ann Surg. 2006;244:1012-7.
Ramakrishnan AS, Mahajan V, Kannan R. Optimizing local control in anorectal melanoma. Indian J Cancer. 2008;45:13-9.
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