Title: A Rare Case of Unusual Malignant Melanoma
Authors: Prof Dr. S.K Mohapatra, Dr L.V Gouri, Dr R .N Guru, Dr N Kabat, Dr Dharbind Kumar Jha, Dr B Samantaray, Dr Goguldeep Veluswamy
DOI: http://dx.doi.org/10.18535/jmscr/v4i7.80
This report presents a case of “Advanced anal verge melanoma with secondaries in left inguinal lymph node , liver and vesico-uterine angle”. A 55year old female presented with complain of bleeding per rectum for 2 years and mass coming out through anus for 8 days. Local examination revealed a pedunculated lobular growth from the perianal verge with blackish discolouration along with left inguinal lymphadenopathy. On ultrasonography and CT Scan metastatic deposits in liver and vesicouterine angle was detected. This case report demonstrates the aggressive nature of the disease and hence gives a message to have a high index of suspicion for any case of rectal bleeding with lightly pigmented or non pigmented polypoid lesion on proctoscopic examination for early diagnosis and treatment. 1. Klas JV, Rothenberger DA, Wong WD, Madoff RD: Malignant tumors of the anal canal: the spectrum of disease, treatment, and outcomes. Cancer 1999, 85:1686-1693. 2. Chang AE, Karnell LH, Menck HR: The National Cancer Data Base report on cutaneous and noncutaneous melanoma: a summary of 84,836 cases from the past decade. The American College of Surgeons Commission on Cancer and the American Cancer Society. Cancer 1998, 83:1664-1678. 3. Helmke BM, Otto HF: Anorectal melanoma. A rare and highly malignant tumor entity of the anal canal. Pathologe 2004, 25:171-7. 4. Ishizone S, Koide N, Karasawa F, Akita N, Muranaka F, Uhara H, Miyagawa S: Surgical treatment for anorectal malignant melanoma: report of five cases and review of 79 Japanese cases. Int J Colorectal Dis 2008, 23:1257-1262. 5. Winburn GB: Anal carcinoma or "just hemorrhoids"? Am Surg 2001, 67:1048-58. 6. Hillenbrand A, Barth TFE, Henne-Bruns D, Formentini A: Anorectal amelanotic melanoma. Colorectal Disease 2007, 10:612-615. 7. Podnos YD, Tsai NC, Smith D, Joshua DI: Factors affecting survival in patients with anal melanoma. Am Surgeon 2006, 72:917-920. 8. Yeh JJ, Shia J, Hwu WJ, Busam KJ, Paty PB, Guillem JG, Coit DG, Wong WD, Weiser MR: The role of abdominoperineal resection as surgical therapy for anorectal melanoma. Ann Surg 2006, 244:1012-7. 9. Yap LB, Neary P: A comparison of wide local excision with abdominoperineal resection in anorectal melanoma. Melanoma Res 2004, 14:147-150. 10. Ballo MT, Gershenwald JE, Zagars GK, Lee JE, Mansfield PF, Strom EA, Bedikian AY, Kim KB, Papadopoulos NE, Prieto VG, Ross MI: Sphincter- sparing local excision and adjuvant radiation for anal-rectal melanoma. J Clin Oncol 2002, 20:4555-8. 11. Olsha O, Mintz A, Gimon Z, Gold Deutch R, Rabin I, Halevy A, Reissman P: Anal melanoma in the era of sentinel lymph node mapping: a diagnostic and therapeutic challenge. Tech Coloproctol 2005, 9:60-2. 12. Moozar KL, Wong CS, Couture J: Anorectal malignant melanoma: treatment with surgery or radiation therapy, or both. Can J Surg 2003, 46:345-9. 13. Ulmer A, Metzger S, Fierlbeck G: Successful palliation of stenosing anorectal melanoma by intratumoral injections with natura interferon-beta. Melanoma Res 2002, 12:395-8. 14. Yeh JJ, Weiser MR, Shia J, Hwu WJ: Response of stage IV anal mucosal melanoma to chemotherapy. Lancet Oncol 2005, 6:438-9. 15. Kim KB, Sanguino AM, Hodges C, Papadopoulos NE, Eton O, Camacho LH, Broemeling LD, Johnson MM, Ballo MT, Ross MI, et al.: Biochemotherapy in patients with metastatic anorectal mucosal melanoma. Cancer 2004, 100:1478-1483. 16. Ueno H, Hase K, Mochizuki H: Criteria for extramural perineural invasion as a prognostic factor in rectal cancer. Br J Surg 2001, 88:994-1000. 17. Weyandt GH, Eggert AO, Houf M, Raulf F, Bröcker EB, Becker JC: Anorectal melanoma: surgical management guidelines according to tumour thickness. Br J Cancer 2003, 89:2019-2022. 18. Guren MG, Eriksen MT, Wiig JN, Carlsen E, Nesbakken A, Sigurdsson HK, Wibe A, Tveit KM: Quality of life and functional outcome following anterior or abdominoperineal resection for rectal cancer. Eur J Surg Oncol 2005, 31:735-42. 19. Belli F, Gallino G, Tragni G, Andreola S, Leo E: Surgical and pathological prognostic factors in anorectal melanoma: The Experience of the National Cancer Institute of Milano. Proceedings 12th Congress of the European Society of Surgical Oncology. Budapest 2004:77.Abstract
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