Challenges in managing anorectal melanoma, a rare malignancy. (April 2023)

• Record Type: Journal Article
• Authors: Biswas, Jyotirmoy; Bethineedi, Lakshmi Deepak; Dhali, Arkadeep; Miah, Jamal; Ray, Sukanta; Dhali, Gopal Krishna
• Is Part Of: International journal of surgery case reports. Volume 105(2023)
• Publication Date: 2023-04
• Subjects: Anorectal growth -- Melanoma -- Surgery -- Outcome; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2023.108093
• Languages: English
• ISSNs: 2210-2612

Abstract

Abstract: Introduction and importance: Anorectal melanoma is a rare and aggressive malignancy that can be difficult to diagnose due to its nonspecific presentation. Case presentation: We present a case of a 69-year-old woman who presented with painful defecation, bleeding per rectum, and a mass coming out of her anal opening. The initial differential diagnosis included hemorrhoids, rectal polyp, or a malignant lesion of the rectum. However, histopathological evaluation following transanal excision of the rectal mass revealed mucosal melanoma in the anorectal region. Further investigation showed no evidence of locoregional or distant metastasis. Clinical discussion: Surgery remains the primary treatment option for anorectal melanoma, but complete resection is often not feasible, leading to high rates of local recurrence and distant metastasis. The incidence of metastatic disease at the time of presentation is high, and a multidisciplinary approach is necessary to manage these patients. Currently, standard systemic therapies used for cutaneous melanoma are the mainstay of treatment for metastatic anorectal melanoma, but there is a need for further research to develop tailored treatment strategies. Conclusion: Our case report highlights the importance of considering anorectal melanoma in the differential diagnosis of patients presenting with anorectal symptoms. It emphasizes the need for a multidisciplinary approach to managing this rare malignancy. Early diagnosis, a multidisciplinary approach, and ongoing research into more effective treatments are crucial for improving outcomes for patients with anorectal melanoma. Highlights: Anorectal melanoma is a rare and aggressive malignancy. It can be difficult to diagnose due to its nonspecific presentation. It should be considered as a differential diagnosis for patients presenting with anorectal symptoms. Surgery remains the primary treatment option.