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Primary anorectal malignant melanoma: a case report
Ju-Ji Dai1, Chun-Sheng Qu2, Wei Wang2
1Department of Colorectal Surgery, The First Affiliated Hospital of Wenzhou Medical University Wenzhou, China.
International Journal of Clinical and Experimental Pathology
|March 27, 2020
Summary
Anorectal melanoma (ARM) is a rare and aggressive cancer. This case highlights the need for immunohistochemistry in diagnosing ARM and emphasizes radical surgery as the primary treatment.
Area of Science:
- Oncology
- Surgical Pathology
Background:
- Anorectal melanoma (ARM) is an exceptionally rare and aggressive malignancy.
- Early diagnosis and effective treatment are crucial for improving patient outcomes.
Observation:
- A 48-year-old woman presented with rectal swelling and bleeding, diagnosed with a 5x6 cm anterior rectal mass.
- The mass, located 3 cm from the anal verge, was surgically resected via abdominoperineal resection (APR).
Findings:
- Histopathological analysis confirmed Anorectal Melanoma (ARM), positive for S-100 and Melan A, with a high Ki67 proliferation index (70%).
- The tumor showed deep invasion into the adventitia and metastasis to 16/16 lymph nodes.
- Widespread metastasis to the liver, spleen, pancreas, lung, and subcutaneous tissue occurred within three months post-surgery.
Implications:
- Pre-operative biopsies may not be sufficient for definitive ARM diagnosis; immunohistochemistry is essential.
- Oncological radical surgical resection remains the gold standard treatment for Anorectal Melanoma (ARM).
- The aggressive nature of ARM necessitates timely and comprehensive diagnostic and therapeutic strategies.
