Malignant Melanoma of Anal Canal – A Diagnostic Dilemma

  • Bushra Siddiqui Department of Pathology, JN Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
  • Shahbaz Habib Faridi Department Of Surgery, JN Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.
  • Syed Shamshad Ahmad Department of Pathology, JN Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
  • Kafil Akhtar Department of Pathology, JN Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
  • Suhailur Rehman Department of Pathology, JN Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
  • Mohsin Aijaz Department of Pathology, JN Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
Keywords: Malignant Melanoma, cutaneous Malignancies, Anal Canal

Abstract

A 50-year-old male presented with major complaints of bleeding per -rectum and generalized weakness for past one and a half month. Digital rectal examination (DRE) and colonoscopy revealed a thrombosed internal haemorrhoid, which was surgically excised. Histopathological examination (HPE) was pointing towards anal malignant melanoma, which was further confirmed by positive immunohistochemistry (IHC) for HMB-45. As the patient had no secondaries or lymph node enlargement, he was referred for loco-regional radiotherapy.

Primary ano-rectal melanoma is a rare but locally aggressive neoplasm capable of early metastasis. Owing to its non-specific clinical presentation it may be mistaken for benign conditions like haemorrhoids and may prove fatal.  Surgical treatment may range from wide local excision (WLE) to abdomino-perineal resection (APR) with controversial role of chemo-radiation in advanced cases. Prognosis is usually bleak with a 5-year survival rate of less than 20%. Owing to the rarity of ano-rectal melanoma and importance of its early detection and management, this case is being reported here.

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References

1. Carcoforo P, Raiji MT, Palini GM, Pedriali M, Maestroni U, Soliani G et al. Primary anorectal melanoma: an update. J Cancer 2013; 3:449e453.
2. Tomioka K, Ojima H, Sohda M, Tanabe A, Fukai Y, Sano A et al. Primary malignant melanoma of the rectum: report of two cases. Case Rep Surg. 2012;2012:247348.
3. Trzcinski R, Kujawski R, Mik M, Sygut A, Dziki L, Dziki A. Malignant melanoma of the anorectum-a rare entity. Langenbecks Arch Surg. 2010;395:757-60.
4. Nivatvongs S. Perianal and anal canal neoplasms. In: Gordon PH, Nivatvongs S, eds. Colon, Rectum and Anus. 3rd ed. New York: Informa Healthcare; 2007:369-390.
5. Garrett K, Kalady MF. Anal neoplasms. Surg Clin North Am 2010; 90:147-161.
6. Van Schaik P, Ernst M, Meijer H, Bosscha K. Melanoma of the rectum: A rare entity. World Journal of Gastroenterology : WJG. 2008;14:1633-1635.
7. Singer M, Mutch MG. Anal melanoma. Clin Colon Rectal Surg 2006;19:78–87.
8. Roviello F, Cioppa T, Marrelli D, Nastri G, De Stefano A, Hako L et al. Primary ano-rectal melanoma: considerations on a clinical case and review of the literature. Chir Ital 2003;55:575-80
9. Khan M, Bucher N, Elhassan A, Barbaryan A, Ali AM, Hussain N et al. Primary Anorectal Melanoma. Case Reports in Oncology. 2014;7:164-170.
10. Akaraviputh T, Arunakul S, Lohsiriwat V, Iramaneerat C, Trakarnsanga A. Surgery for gastrointestinal malignant melanoma: Experience from surgical training center. World Journal of Gastroenterology : WJG. 2010;16:745-748.
11. Chute DJ, Cousar JB, Mills SE. Anorectal malignant melanoma: morphologic and immunohistochemical features. Am J ClinPathol 2006; 126:93–100.
12. Zhang S, Gao F, Wan D. Effect of misdiagnosis on the prognosis of anorectal malignant melanoma. J Cancer Res Clin Oncol 2010;136:1401–1405.
13. Praveen L, Kumar V, Pujahari AK. Lesson Learnt in Anal Melanoma: A Case Report. Indian Journal of Clinical practice 2014; 25: 678-679
Published
2018-02-16
How to Cite
1.
Siddiqui B, Faridi S, Ahmad S, Akhtar K, Rehman S, Aijaz M. Malignant Melanoma of Anal Canal – A Diagnostic Dilemma. IABCR [Internet]. 16Feb.2018 [cited 19Jul.2019];2(2):79-2. Available from: https://iabcr.org/index.php/iabcr/article/view/217