[Primary anorectal melanoma]

To specify the clinical and therapeutic aspects of anorectal melanoma.

Nine cases of malignant anorectal melanoma were managed in the department of gastroenterology of the Ibn Rochd university hospital in Casablanca between 1984 and 2002.

There were 5 men and 4 women, with a mean age of 61 years. Clinical symptoms were dominated by rectal bleeding (7 cases) and rectal syndrome (5 cases). The tumor was blackish in 4 cases. Extension staging showed metastases in the liver in one patient and in the bones in another. One patient had undergone abdominoperineal resection, two transanal tumor resection, and in one patient radiotherapy was applied. Five patients refused any treatment. The outcome was marked by remission in 2 cases with an event free survival respectively of 10 and 21 months. Three patients died because of visceral metastases. Four patients were lost to follow-up.

The prognosis of anorectal melanoma is frightening because of late diagnosis and high malignancy potential. Treatment is based essentially on surgery.