Presentation
Pigmentation was present in 9 cases. Junctional change was present in 6 cases. The mitotic rate was 3 or more per high-power field in 8 cases. [academic.oup.com]
Histological misdiagnosis is frequent as melanin pigment is present in only 30%. Therefore, immunohistochemistry panels can be useful: anti S-100 protein, HMB-45 and melan-A (3). [scielo.isciii.es]
Most of the time presentation will be late, even with the early presentation; the prognosis will be poor due to early regional and distant metastasis. Malignant melanoma anal canal can present with varying presentation. [ccij-online.org]
Case presentation A 63-year-old man presented with a history of blood in the stool. Rectal examination revealed a mass in the lower rectum. [ncbi.nlm.nih.gov]
Entire Body System
- Inguinal Mass
Fine-needle aspiration of the inguinal mass showed secondary deposits of malignant melanoma. Ultrasound abdomen and inguinal region showed right hydroureteronephrosis with multiple liver secondaries. [ccij-online.org]
Changes in bowel movements, rectal pain, and inguinal mass may also be present. Hemorrhoids, polyps, and other malignancies are the most common differential diagnoses [ 3, 4 ]. A mass is usually palpated on digital rectal examination. [ncbi.nlm.nih.gov]
Skin
- Pigmented Tumor
A multi-slice helical chest, abdominal and pelvic CAT scan ruled out metastatic tumors and lymphadenopathy. The patient underwent local transanal excision of the partially pigmented tumor. [scielo.org.co]
Workup
Three patients had extranodal disease on preoperative workup, consisting of metastases to the liver and splenic hilum in one patient, liver alone in one patient, and periportal lymph node disease in one patient. [ascopost.com]
Among the 7 patients treated initially with APR, 4 (57.1%) were found to have positive lymph nodes, including 2 patients who were classified as having stage I disease on initial workup. [jamanetwork.com]
However, there has been limited dedicated evaluation of these modalities in the workup of anorectal melanoma. [oncotarget.com]
Treatment
The most effective treatment strategies for PAMM remain the focus of investigation. [spandidos-publications.com]
Although there is currently no consensus on the treatment methods for AMM, surgical procedures have been the most common treatment methods used until now. [wjgnet.com]
The current treatment for the condition is surgical excision, using different techniques according to the stage of the disease and depth of invasion. [springermedizin.at]
In conclusion, the prognosis of anorectal melanoma is poor, irrespective of surgical treatment. [journals.sagepub.com]
The response of anorectal melanoma to radiotherapy and chemotherapy is poor and optimum surgical treatment is controversial. [indianjcancer.com]
Prognosis
Effect of misdiagnosis on the prognosis of anorectal malignant melanoma. J Cancer Res Clin Oncol 2010;136:1401-5. DOI: 10.1007/s00432-010-0793-z. [ Links ] 3. Duarte P, Ramos R, Vicente C, et al. [scielo.isciii.es]
Indian J Cancer 2009;46:347-8 Sir, Melanoma of anus and / or rectum is a rare but highly malignant tumor with poor prognosis. [indianjcancer.com]
It is a clinical prognosis index of the cancer patient population. In the current case, the patient exhibited a high KPS score following surgery, which indicates a good prognosis. [spandidos-publications.com]
The prognosis is usually poor. [ NCIT : C4639 ] A melanoma arising from the anus. Clinical presentation includes rectal bleeding, tenesmus, pain, and change in bowel habit. [ebi.ac.uk]
Despite the low rates of regional relapse and with 70% of patients presenting with localised and apparently curable disease ( 3 ), the prognosis is poor. [academic.oup.com]
Etiology
ETIOLOGY • No known risk factors. • Risk factors for cutaneous melanoma like nevus, sunlight exposure does not predispose to anal melanoma. 5. [slideshare.net]
Case report of primary rectal melanoma and review of the etiology of melanoma. J Cutan Med Surg 2008;12:117-20. [ PUBMED ] 3. Cooper PH, Mills SE, Allen MS Jr. [jmedsoc.org]
Commonly affect female sex with, male: female ratio 0.75. [4] Anorectal melanoma located on the anal canal or at the anal verge (65%), remaining 35% located in distal rectum. [5] Etiology remains controversial. [ccij-online.org]
While the signature UV-associated 6-4PP and CPD nucleic acid mutations are not found to be the etiology of BRAF mutations, there is evidence that faulty repair of UV-A associated oxidative damage and other UV-B associated mutations may be the etiology [jcancer.org]
Human papillomavirus, smoking, and sexual practices in the etiology of anal cancer. Cancer. 2004 Jul 15. 101 (2):270-80. [Medline]. Učakar V, Jelen MM, Faust H, Poljak M, Dillner J, Klavs I. [emedicine.medscape.com]
Epidemiology
: Changing epidemiology of anorectal melanoma. Dis. Colon Rectum, 42: 1203 – 1208, 1999. Google Scholar | Crossref | Medline 4. [journals.sagepub.com]
Weinstock MA (1993) Epidemiology and prognosis of anorectal melanoma. Gastroenterology 104:174–178 PubMed Google Scholar 6. Longo WE (1995) Rare anal canal cancers in the U.S. veteran: patterns of disease and results of treatment. [link.springer.com]
Epidemiology and prognosis of anorectal melanoma. Gastroenterology 1993; 104:174-8. Marc Singer, Matthew G. Mutch. Anal melanoma. Clin Colon Rectal Surg 2006; 19: 78-87. Wanebo HJ, Woodruff JM, Farr GH, et al. Anorectal melanoma. [ejourpub.com]
Primary melanomas of the esophagus and anorectum: epidemiologic comparison with melanoma of the skin. Melanoma Res. 2009;19:58-60. Ballo MT, Gershenwald JE, Zagars GK, Lee JE, Mansfield PF, Strom EA, et al. [sci-rep.com]
According to a very recent systematic review, until August 2012, a total of 2652 cases of AM had been published, most listed by specialized centers, with review periods not less than 40 years. 7 Epidemiology Epidemiological data on AM is very heterogeneous [elsevier.es]
Pathophysiology
A further complication is that pathophysiologically, cancer of the anal margin (perianal skin) may be more closely related to penile and vulvar cancers than to cervical cancer, and the former are much less well studied than the latter. [10] In current [emedicine.medscape.com]
Prevention
Quick and easy access to the essential content of the guidelines – PowerPoint slides and PDFs including algorithms, figures and tables – free to download Breast Cancer 4th ESO–ESMO International Consensus Guidelines for Advanced Breast Cancer (ABC4) • Prevention [esmo.org]
High-resolution anoscopy or expectant management for anal intraepithelial neoplasia for the prevention of anal cancer: is there really a difference?. Dis Colon Rectum. 2015 Jan. 58 (1):53-9. [Medline]. PDQ Screening and Prevention Editorial Board. [emedicine.medscape.com]
Abstract Copyright © 2016, Iranian Journal of Cancer Prevention. [ijcancerprevention.com]
National Institute for Health and Clinical Excellence (NICE) NICE is an independent organisation responsible for providing national guidance on promoting good health and preventing and treating ill health. [maggiescentres.org]