Long-Term Survivor of Anorectal Melanoma

Abstract

Anorectal melanoma is a rare malignant tumor with approximately 500 cases reported in the literature and has dismal long-term survival prospects. Its poor prognosis is attributable to a delay in diagnosis and its inherent biologic aggressiveness, with many patients presenting with metastatic disease. Endoluminal ultrasound is an established mode of evaluation. The mainstay of treatment is usually surgical with curative or palliative intent. The choice of abdominoperineal resection vs. wide local excision of the tumor is controversial. This is an interesting report of a 76-year-old female who presented with an anal mass, eventually underwent a wide local excision of the lesion, which pathologically proved to be malignant melanoma, and was doing well without any evidence of disease ten years after surgery. This is the only known case in the literature of a lesion of this thickness to be “cured” by wide local excision.