Malik Amara, Hull Tracy L, Milsom Jeffery
Department of Colon and Rectal Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Dis Colon Rectum. 2002 Oct;45(10):1412-5; discussion 1415-7. doi: 10.1007/s10350-004-6435-2.
Anorectal melanoma is a rare malignant tumor with approximately 500 cases reported in the literature and has dismal long-term survival prospects. Its poor prognosis is attributable to a delay in diagnosis and its inherent biologic aggressiveness, with many patients presenting with metastatic disease. Endoluminal ultrasound is an established mode of evaluation. The mainstay of treatment is usually surgical with curative or palliative intent. The choice of abdominoperineal resection wide local excision of the tumor is controversial. This is an interesting report of a 76-year-old female who presented with an anal mass, eventually underwent a wide local excision of the lesion, which pathologically proved to be malignant melanoma, and was doing well without any evidence of disease ten years after surgery. This is the only known case in the literature of a lesion of this thickness to be "cured" by wide local excision.
