Surgical treatment of anorectal melanomas

Melanoma of the rectum: A rare entity

“…Firstly, treatment is often palliative and wide radical surgery unnecessary mutilating. Secondly, tumor stadium and biological behaviour of the tumor determines survival instead of the choice of surgical operation [9,10] . Recent studies show that sphincter-saving local excision combined with adjuvant loco-regional radiotherapy at the primary site of the tumor and the regional pericolic and inguinal lymphatics (5 X 6 GY) results in the same loco-regional control with less loss of function compared to APR (70% vs 74%) [5] .…”

Malignant Melanoma of the Anorectal Area

“…In patients with lesions thicker than 2 mm, no 5-year survivors have been reported, and 85% live less than 2 years. Other factors affecting the prognosis include delay in diagnosis [2-4, 14, 20] and the stage of the disease at the time of diagnosis [4,9,13]. In Dukes stage I the mean survival is 48.1 months, in Dukes stage II 12.4 months, in Dukes stage III 10.1 months, and in Dukes stage IV 5 months.…”

“…Primary anorectal melanoma is a rare tumor comprising 0.4-1.6% [1][2][3][4] of all melanomas and 1-3% [1,2,[4][5][6] of all primary anorectal tumors. Anorectal melanoma was first described in 1857 by Moore, and subsequently about 300 cases have been reported in the literature [2,[7][8][9][10] including 21 cases treated at St. Mark's Hospital of London during the last 44 years [6].…”

Das anorektale Melanom?eine seltene Manifestation

“…Ein Vorteil hinsichtlich des Langzeitüberlebens ist bislang durch eine systematische Leistenausräumung nicht gesichert. Die Patientendaten sind bei weitem zu gering, um durch eine prophylaktische bilaterale Leistendissektion eine signifikante Lebensverlängerung ableiten zu können [18,23].Wesentlich häufiger wird eine Leistendissektion erst bei auffälligem Befund durchgeführt.Vergleichende Studien sind in der Literatur nicht zu finden. Im Zweifel ist analog zum kutanen Melanom die Durchführung einer "Sentinel Lymphnode Biopsy" für den Nachweis von okkulten Lymphknotenmetastasen hilfreich [10].…”