Primitive Anorectal Malignant Melanoma: A Rare But Aggressive Tumor

Ahmed Ballati,Asma Elkarouachi,Driss Erguibi,Farid Chehab,Mohamed Asmar,Rachid Boufettal,Saad Rifki Jai

doi:10.24018/ejmed.2020.2.2.175

Ahmed Ballati, Asma Elkarouachi + Show 5 more

Open Access

https://doi.org/10.24018/ejmed.2020.2.2.175

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Abstract

We report 2 observations of primary anorectal melanoma, collected over a period of 2 years from December 2017 to December 2019, as well as data from the literature. The patients nevertheless benefited after the histological evidence with an additional immunohistochemical study of an extension assessment made by pelvic MRI and thoracoabdominopelvic CT scan. The patients were classified stage I according to the Slingluff classification. They underwent abdominoperineal resection with definitive left iliac colostomy and adjuvant Chemotherapy.

Highlights

The primary anorectal melanoma remains a very rare entity, less than 2% of melanomas, and is third after the skin and retina [1]. This tumour has a slight female predominance and occurs mainly between the sixth and seventh decade [2].The cornerstone of the treatment remains surgery, two options are available to the surgeon which are local resection or abdominoperineal resection, whose results in terms of survival remain almost comparable, but the latter offers better local control of the disease.The prognosis is poor because patients present in advanced stages due to the high metastatic potential
A thoracoabdominopelvic CT scan was requested as part of the extension work-up revealing a tumour process from the anal canal extended to the lower rectum by 64 mm, stenosing, developed essentially at the expense of the right anterolateral surface and responsible for a stenosis of the digestive lumen essentially distally
Surgery is the treatment of choice for primary anorectal melanomas, but its modalities of removal, either localized or abdominoperineal resection, remain controversial [7]

Summary

INTRODUCTION

The primary anorectal melanoma remains a very rare entity, less than 2% of melanomas, and is third after the skin and retina [1]. This tumour has a slight female predominance and occurs mainly between the sixth and seventh decade [2].The cornerstone of the treatment remains surgery, two options are available to the surgeon which are local resection or abdominoperineal resection, whose results in terms of survival remain almost comparable, but the latter offers better local control of the disease.The prognosis is poor because patients present in advanced stages due to the high metastatic potential. Histological examination of the specimen, with a neoplasm of 9*8 cm, revealed a malignant tumour proliferation of the round-cell rectum compatible with melanoma

Case 1

DISCUSSION

Findings

CONCLUSION