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A Rare Entity: Primary Malignant Melanoma of the Anorectum

아주 드문 항문직장 악성 흑색종

  • Jeongmin Choi (Division of Gastroenterology, Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Jong Whan Kim (Division of Gastroenterology, Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine)
  • 최정민 (인제대학교 의과대학 상계백병원 소화기내과 ) ;
  • 김종환 (인제대학교 의과대학 상계백병원 소화기내과 )
  • Received : 2024.03.27
  • Accepted : 2024.04.08
  • Published : 2024.04.20

Abstract

Malignant melanomas, which are rarely found in the Asian population, are malignant tumors or melanocytes that manifest in the skin mucosa. Malignant melanomas of the anorectum are very rare and account for approximately 1% of all malignant melanomas in the Asian population. Here, we present a rare case presenting a malignant melanoma of the anorectum. An 85-year-old woman visited the hospital with bloody stools and an anal mass. Sigmoidoscopy revealed a black mass protruding from the anus, and the scope was able to penetrate the anorectal mass. Close-up endoscopy revealed black moles of different sizes scattered across the rectal mucosa. PET-CT indicated multiple FDG uptakes in the liver, indicating multiple metastases. Pathologic examination led to the detection of malignant melanocytes with dark brown deposits. The patient's immunohistochemical markers were positive for melanin-A antibodies and HMB-45, indicating a malignant melanoma. As there was no evidence of malignant melanomas on the skin, the patient was diagnosed with primary malignant anorectal melanoma with liver metastases.

Keywords

References

  1. Chen H, Cai Y, Liu Y, et al. Incidence, surgical treatment, and prognosis of anorectal melanoma from 1973 to 2011: a population-based SEER analysis. Medicine (Baltimore) 2016;95:e2770. https://doi.org/10.1097/MD.0000000000002770 
  2. Pham BV, Kang JH, Phan HH, Cho MS, Kim NK. Malignant melanoma of anorectum: two case reports. Ann Coloproctol 2021;37:65-70. https://doi.org/10.3393/ac.2020.01.07.1 
  3. Gleason BC, Nascimento AF. HMB-45 and Melan-A are useful in the differential diagnosis between granular cell tumor and malignant melanoma. Am J Dermatopathol 2007;29:22-27. https://doi.org/10.1097/01.dad.0000249888.41884.6c 
  4. Goldstein BG, Goldstein AO. Diagnosis and management of malignant melanoma. Am Fam Physician 2001;63:1359-1369. 
  5. Kohoutova D, Worku D, Aziz H, Teare J, Weir J, Larkin J. Malignant melanoma of the gastrointestinal tract: symptoms, diagnosis, and current treatment options. Cells 2021;10:327. https://doi.org/10.3390/cells10020327 
  6. Larkin J, Chiarion-Sileni V, Gonzalez R, et al. Five-year survival with combined nivolumab and ipilimumab in advanced melanoma. N Engl J Med 2019;381:1535-1546. https://doi.org/10.1056/NEJMoa1910836 
  7. Chapman PB, Hauschild A, Robert C, et al. Improved survival with vemurafenib in melanoma with BRAF V600E mutation. N Engl J Med 2011;364:2507-2516. https://doi.org/10.1056/NEJMoa1103782