Anal melanoma: a rare, but catastrophic tumor

Abstract

Abstract Introduction Malignant melanoma of the anal canal is a rare and aggressive disease, which early diagnosis is difficult. Its presentation with no specific symptoms leads to a late diagnosis at an advanced stage. The prognosis of anorectal malignant melanoma is poor and frequently related to distant metastasis and absence of response of chemoradiotherapy. Surgery remains the mainstay of therapy; otherwise, the best approach is controversial. Considering no survival benefits for APR, wide local excision should be considered as the treatment of choice. Methods This report collects nine cases of anorectal melanoma treated at our division from 1977 to 2006, as well as a review of the literature. Results There were eight females and one male, of medium age 69 years (range: 41-85 years). Most frequent presentation was bleeding. Wide Local Excision (WLE) was performed in seven of them. Mean survival was 24 months, and six of them died on account of metastatic disease. Conclusion Anorectal melanoma remains challenging. Efforts should be taken to early diagnosis, and wide local excision with negative margins is the preferred treatment. Abdominoperineal resection (APR) is a reasonable option for bulky tumors or when the sphincter is invaded.