Papanikolaou Georgios E, Tsimogiannis Konstantinos, Kampletsas Eleftherios, Chatzoglou Theocharis, Varvarousis Dimitrios N
Department of Plastic Surgery, Metropolitan General Hospital, Athens, GRC.
Department of Medicine, University of Ioannina, Ioannina, GRC.
Cureus. 2024 Nov 18;16(11):e73931. doi: 10.7759/cureus.73931. eCollection 2024 Nov.
Anorectal melanoma (ARM) is a rare entity with aggressive biological behavior and poor prognosis. Clinically, ARM presents with atypical symptoms, such as anal pain and bleeding, thus often being misdiagnosed as a benign anorectal pathology and leading to delayed diagnosis. We present a case of a 73-year-old female patient with stage I ARM, treated successfully with a combination of neoadjuvant-adjuvant immunotherapy (nivolumab, an anti-PD-1 monoclonal antibody) and abdominoperineal resection. The patient is disease-free at a five-year follow-up after the operation, suggesting that long-term targeted immunotherapy offers a durable and promising response. This case highlights the critical role of a multidisciplinary approach, involving specialists in ARM surgery and systemic therapies, to improve prognosis and ensure an optimal quality of life for patients with ARM. Given the limited scientific evidence, further prospective and randomized trials are required to develop effective systemic therapies and improve the survival of patients with ARM.
肛管黑色素瘤（ARM）是一种罕见的疾病，具有侵袭性生物学行为且预后较差。临床上，ARM表现为非典型症状，如肛门疼痛和出血，因此常被误诊为良性肛管病变，导致诊断延迟。我们报告一例73岁I期ARM女性患者，通过新辅助-辅助免疫治疗（纳武单抗，一种抗PD-1单克隆抗体）联合腹会阴切除术成功治疗。术后五年随访时患者无疾病，表明长期靶向免疫治疗可提供持久且有前景的反应。该病例突出了多学科方法的关键作用，包括ARM手术和全身治疗专家，以改善预后并确保ARM患者的最佳生活质量。鉴于科学证据有限，需要进一步进行前瞻性和随机试验，以开发有效的全身治疗方法并提高ARM患者的生存率。
