Primary malignant melanoma of the rectum: rationale for conservative surgical management

A case of malignant melanoma arising in the rectum is described and the literature is reviewed. The natural history of melanoma of the rectum is distinctive from that of other tumors of the perineal area in that local recurrence is uncommon and systemic dissemination is frequent, with a low cure rate (2/66 in a literature review). Conservative surgical approaches (fulguration, local resection) are recommended in preference to abdominoperineal resection in that palliation is the realistic goal of surgical therapy.