Primary anorectal melanoma: a case of 5 year disease-free survival
DOI:
https://doi.org/10.18203/2349-2902.isj20170230Keywords:
Anorectal, Bleeding, Melanoma, Surgery, TherapyAbstract
Anorectal melanoma is a rare cause of anorectal malignancies affecting mainly elderly people without significant gender differences, although there seems to be a white predominance. Diagnosis is often challenging, since symptoms are frequently nonspecific. Radical surgery is the mainstay of treatment, while adjuvant therapies are generally of limited value. Thus, prognosis is still grim, with a 5-year survival rate of less than 20%. We report the case of a 75-year-old white female presenting with mild anal pain and blood in stools. Diagnosed with an ulcerated melanoma of the perianal area, she eventually underwent an abdominoperineal resection and bilateral inguinal lymphadenectomy. To date, she is currently alive and disease-free. Given the lack of adequate international guidelines, we recommend defining a tailored treatment by thorough multidisciplinary discussion, as well as taking into account the patient personal preference.
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Khan M, Bucher N, Elhassan A, Barbaryan A, Ali AM, Hussain N, Mirrakhimov AE. Primary anorectal melanoma. Case Rep Oncol. 2014;7:164-70.
Chang AE, Karnell LH, Menck HR. The National cancer data base report on cutaneous and noncutaneous melanoma: a summary of 84, 836 cases from the past decade. Cancer. 1998;83:1664-78.
Chen H, Cai Y, Liu Y, He J, Hu Y, Xiao Q, et al. Incidence, surgical treatment, and prognosis of anorectal melanoma from 1973 to 2011: a population-based SEER analysis. Medicine. 2016;95(7):2770.
Moore WD. Recurrent melanosis of the rectum, after previous removal from the verge of the anus, in a managed sixty-five. Lancet. 1857;1:290.
Morson BC, Volkstadt H. Malignant melanoma of the anal canal. J Clin Pathol. 1963;16(2):126-32.
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.
Cagir B, Whiteford MH, Topham A, Rakinic J, Fry RD. Changing epidemiology of anorectal melanoma. Dis Colon Rectum. 1999;42:1203-8.
Chang Y, Cesarman E, Pessin MS, Lee F, Culpepper J, Knowles DM, Moore PS. Identification of herpesvirus-like DNA sequences in AIDS-associated Kaposi’s sarcoma. Science. 1994;266:1865-9.
Helmke BM, Deichmann M, Otto HF. Anorectal melanomas do not harbour the Kaposi sarcoma-associated human herpesvirus type 8 DNA. J Med Virol. 2001;64:47-50.
Pessaux P, Pocard M, Elias D, Duvillard P, Avril MF, Zimmerman P, Lasser P. Surgical management of primary anorectal melanoma. Br J Surg. 2004;91:1183-7.
Singer M, Mutch MG. Anal melanoma. Clin Colon Rectal Surg. 2006;19:78-87.
Chute DJ, Cousar JB, Mills SE. Anorectal malignant melanoma: morphologic and immune histochemical features. Am J Clin Pathol. 2006;126:93-100.
Abbas JS, Karakousis CP, Holyoke ED. Anorectal melanoma: clinical features, recurrence and patient survival. Int Surg. 1980;65:423-6.
Brady MS, Kavolius JP, Quan SHQ. Anorectal melanoma: a 64-year experience at Memorial Sloan Kettering Cancer Center. Dis Colon Rectum. 1995;38:146-51.
Mutch MG, Roberts PL. Anal and peri-anal melanoma. Clin Colon Rectal Surg. 2002;15:271-6.
Felz MW, Winburn GB, Kallab AM, Lee JR. Anal melanoma: an aggressive malignancy masquerading as hemorrhoids. South Med J. 2001;94:880-5.
Slingluff C, Collmer R, Seigler H. Anorectal melanoma: clinical characteristics and results of surgical management in twenty-four patients. Surgery. 1990;107:1-9.
Weyandt GH, Eggert AO, Houf M, Raulf F, Bröcker EB, Becker JC. Anorectal melanoma: surgical management guidelines according to tumour thickness. Br J Cancer. 2003;89:2019-22.
Falch C, Mueller S, Kirschniak A, Braun M, Koenigsrainer A, Klumpp B. Anorectal malignant melanoma: curative abdominoperineal resection: patient selection with 18F-FDG-PET/CT. WJSO. 2016;14(1):185.
Dematos P, Tyler DS, Seigler HF. Malignant melanoma of the mucous membranes: a review of 119 cases. Ann Surg Oncol. 1998;5:733-42.
Kohlii S, Narang S, Singhal A, Kumar V, Kaur O, Chandoke R. Malignant melanoma of the rectum. J Clin Imaging Sci. 2014;4:4.
Slingluff CL, Seigler HF. Anorectal melanoma: clinical characteristics and the role of abdominoperineal resection. Ann Plast Surg. 1992;28:85-8.
Ballo MT, Gershenwald JE, Zagars GK, Lee JE, Mansfield PF, Strom EA, et al. Sphincter-sparing local excision and adjuvant radiation for anal-rectal melanoma. J Clin Oncol. 2002;20:4555-8.
Kong X, Liu Q, Lin G, Zhao D, Qiu H, Cui Q. The first attempt in local excision of anorectal malignant melanoma using transanal endoscopic microsurgery. Int J Clin Exp Pathol. 2015;8(9):11735-40.
Thibault C, Sagar P, Nivatvongs S, Ilstrup DM, Wolff BG. Anorectal melanoma: an incurable disease? Dis Colon Rectum. 1997;40:661-8.
Nishina T, Kunieda K, Miya K, Saji S, Shimokawa K, Katada M, Watanabe K. Two cases of anorectal malignant melanoma showing prolonged survival after local additional excision followed by biopsy and abdomino - perineal resection followed by incisional biopsy. Jpn J Gastroenterol Surg. 2001;34:292-6.
Bullard KM. Surgical therapy for anorectal melanoma. J Am Coll Surg. 2003;196:206-11.
Zhou HT, Zhou ZX, Zhang HZ, Bi JJ, Zhao P. Wide local excision could be considered as the initial treatment of primary anorectal malignant melanoma. Chin Med J. 2010;123:585-8.
Iddings DM, Fleisig AJ, Chen SL, Faries MB, Morton DL. Practice patterns and outcomes for anorectal melanoma in the USA, reviewing three decades of treatment: is more extensive surgical resection beneficial in all patients? Ann Surg Oncol. 2010;17:40-4.
Tien HY, Mcmasters KM, Edwards MJ, Chao C. Sentinel lymph node metastasis in anal melanoma. Int J Gastrointestinal Cancer. 2002;32:53-6.
Mistrangelo M, Morino M. Sentinel lymph node biopsy in anal cancer: a review. Gastroentérologie Clinique Biologique. 2009;33:446-50.
Carcofor P, Raiji MT, Palini GM, Pedriali M, Maestroni U, Soliani G, et al. Primary anorectal melanoma: an update. J Cancer. 2012;3:449-53.
Ciarrocchi A, Pietroletti R, Carlei F, Amicucci G. Extensive surgery and lymphadenectomy do not improve survival in primary melanoma of the anorectum: results from analysis of a large database (SEER). Colorectal Dis 2016.
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