Optimizing local control in anorectal melanoma

As, Ramakrishnan; Mahajan, Vandana; Kannan, Ravi

doi:10.4103/0019-509x.40641

Cited by 27 publications

(21 citation statements)

References 21 publications

(52 reference statements)

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“…It was also considered to be more thorough in excision so that it had some advantages in controlling the relapse, especially for the early-stage patients [22] . Now it is generally considered that the operation type should be individualized [23] . The local wide excision should be the preferable treatment when the tumor is excisable.…”

Section: Discussionmentioning

confidence: 99%

Anorectal malignant melanoma: Diagnosis and treatment of 42 cases

Lin

Zhang

2010

Chin. J. Cancer Res.

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Objective: Anorectal malignant melanoma (AMM) is a rare and aggressive malignant tumor, and its treatment still controversial. This study was to investigate and summarize our experience on diagnosis, treatment and misdiagnosis of AMM.Methods: From August 1980 to December 2009, 42 patients with AMM were treated in our hospital. The clinical data of those patients were retrospectively analyzed, including the major symptoms, treatment and prognosis. Further immunophenotyping analyses using antibodies to S-100 protein, HMB-45 reactive antigen and vimentin were performed in 22 specimens.Results: The major complaints among the 42 cases were hematochezia (23/42, 55.0%), anal masses (12/42, 28.6%), changes in stool character (4/42, 9.5%), and anal tenesmus or pain (3/42, 7.1%). The misdiagnosis rate was 62% (26/42), the most common misdiagnosis consisted of hemorrhoid (9/26, 34.6%), polyps (11/26, 42.3%) and rectal cancer (6/26, 23.1%). 28 cases underwent abdominoperineal resection, 10 underwent local wide excision, 3 underwent palliative operation, and 1 with no operation. After surgery, 15 patients underwent radiotherapy, 21 underwent chemotherapy and 8 were treated with both. 22 cases deceased within 1 year, 11 within 2 years, 5 within 3 years and 1 within 4 years. The median survival time was 11 months, with the longest of 45 months. The immunohistochemical findings revealed that the S-100 protein was present in all 22 cases (100%), HMB-45 was stained in 19 of 22 (86.4%) and vimentin in 21 of 22 (95.5%).Conclusion: AMM is a rare disease with a poor prognosis and with an aptitude of being misdiagnosed. Hematochezia is the most common symptom. Immunohistochemical staining is conducive to the diagnosis of AMM. Operation is the major treatment， the operation type should be individualized.

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Section: Discussionmentioning

confidence: 99%

Anorectal malignant melanoma: Diagnosis and treatment of 42 cases

Lin

Zhang

2010

Chin. J. Cancer Res.

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“…They tend to spread sub mucosally and by the time they cause symptoms, they are often beyond surgical cure. Rectal melanomas account for less than 3% of all melanomas and are more common in females as compared to males (McLaughlin et al, 2005;Wanebo et al, 1981;Ramakrishnan et al, 2008). Once a rectal mass is noted, pigmentation is a clue for diagnosis of melanoma; however, macroscopic pigmentation is not always present.…”

Section: Resultsmentioning

confidence: 99%

“…The patients present with bleeding, diarrhea, tenesmus and severe pain on defaecation (Wanebo et al, 1981;Ramakrishnan et al, 2008). The black brown ulceroproliferative tumor is often visible and is always palpable as a nodule or induration, without or with inguinal lymphadenopathy (20%).…”

Section: Resultsmentioning

confidence: 99%

Anal melanomas: The sun does not shine on this mucosa

Rekha¹,

Joseph²,

Pai³

2014

Med. Pract. Rev.

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Cutaneous melanomas are rare in the Indian population and mucosal and anorectal lesions are seen but very occasionally. They often masquerade as hemorrhoids leading to delay in diagnosis. This was a retrospective study done in Sri Ramachandra University, where hospital records were perused to record all cases of anal melanomas. Abdomino-perineal resection and wide local excision offer equal survival rates. Novel targeted therapy represents the cutting edge of therapy today.

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“…[3] The initial symptom of presentation is bleeding per rectum, and the patient may delay consultation assuming symptoms to be hemorrhoidal disease. [4,5] Surgery remains the mainstay of the treatment, but the surgical therapy is uncertain and controversial. Surgical management includes a conservative approach of wide local excision (WLE) of the tumor or a more radical approach of abdominoperineal resection (APR).…”

Section: Primary Malignant Melanoma Of Anorectum: a Rare Entitymentioning

confidence: 99%