Primary Melanoma of the Anorectum Report of Three Cases

Park, Jng Hyun; Lee, Sang Kuon; Oh, Sung Taek; Kim, Se Kyung; Kim, In Chul

Abstract

Primary melanoma of anorectum is a very rare, aggressive tumor with a reported 5-year survival rate of 6%. Over 90% of all anorectal melanomas arise at the dentate line, but primary lesions well above this line in the rectum or rectosigmoid have been reported. Surgical treatments of this virulent tumor have ranged from conservative approach, such as wide local excision to abdominoperineal resection (APR) with or without bilateral inguinal lymphadenectomy. When wide local excision was compared to APR in terms of survival, no significant difference was noted. However, five-year survivors had 2 mm thin lesion, and underwent radical surgery. We have experienced three cases of primary anorectal melanoma, two of which underwent radical surgery and survived 20 months and 6 months respectively. One patient had wide local excision, and survived 5 months. One of the three patient had von Recklinghausen disease with caf -au-lait spots and primary melanoma, which is probably one of the first reported case in the literature.