Polypoid anal melanoma. A case report and review of the literature.

INTRODUCTION

Ano-rectal melanoma is an uncommon finding in patients complaining of rectal bleeding and/or anal mass often misinterpreted as a haemorroidal pile.

CASE REPORT

A 55-years-old woman, complaining of rectal bleeding, frequent anal pain and anal mass suspected for haemorroidal thrombosis was referred for evaluation and possible treatment. A brown polypoid mass arising from the anal canal/lower rectum with a maximum diameter of 6 cm was diagnosed. The hystological examination of the neoplasm, transanally removed, revealed the presence of a polypoid melanoma partially involving the resection margin. Nor metastases nor limph-node involvement were found at the total-body CT scan and at a CT-PET. C-KIT examination was negative. Multidisciplinary evaluation recommended an abdominoperineal resection followed by an adjuvant chemotherapy as the only possible salvage treatment. To date the patient has refused it.

DISCUSSION

The delay in the diagnosis of an anal melanoma is well-known, bringing frequently to treat advanced stages of the disease that to date has no clear guidelines for the treatment.

KEY WORDS

Ano-rectal melanoma, Mucosal melanoma, Rectal bleeding.