Primary malignant melanoma of anorectum: A rare entity

Anorectal melanoma and seborrheic dermatitis - a case report

“…Ross with colleagues showed a 29% recurrence rate in primary ARM after APR, and a 58% recurrence rate after WLE [26]. In a study by Thibault et al [13], 37 patients had curative resection with no significant survival difference between WLE and APR when comparing disease stage and five-year survival. Before 1997, approximately 70% of all patients underwent APR, while after 1997 almost 90% of patients underwent WLE [14].…”

“…ARM is a rare disease with exceedingly poor prognosis, worse than cutaneous melanoma, with a median survival of one year and with five-year survival rate of 10% [12]. ARM could be located in the anal canal or at the anal verge (2/3), or in the distal rectum (1/3), and often presents with non-specific local symptoms such as rectal bleeding (55%), rectal masses (34%), anal pain (13%), and change in bowel habits (63%) [13,14]. However, women are more likely than men to be diagnosed with ARM (male to female ratio is 0.75) [15], and lesions are usually non-specific, amelanotic, and commonly mistaken for benign conditions such as hemorrhoids or rectal polyposis, which prolongs the establishment of the diagnosis [16,17].…”

“…Before 1997, approximately 70% of all patients underwent APR, while after 1997 almost 90% of patients underwent WLE [14]. The benefits of WLE are obvious, and include fast recovery time from a significantly less invasive procedure, minimal impact on bowel function, and avoidance of permanent colostomy [13]. WLE with or without adjuvant therapy seems to offer good locoregional control without reducing the survival rate, and may be a therapeutic modality of choice for patients with small, superficial ARM [14,27].…”