Primary Ano-rectal Melanoma- A Rare but lethal entity
Abstract
Background: Primary ano-rectal malignant melanoma (ARMM) is rare but aggressive tumor. After skin and retina though this is the third most common site of melanoma. It accounts only for approximately 0.5% of all colorectal or anal cancers. Symptoms include passing of blood with stools, anal pain, and changes in bowel habits or rectal mass.
Material and methods: The study was carried in the department of pathology sher-i-Kashmir institute of medical sciences soura Srinagar. A total of five cases that underwent surgery for anorectal mass and diagnosed as primary anorectal melanoma were included in the study. Retrospective records of 8 years (January 2010 to December 2017) were examined.
Results: 5 cases of ano-rectal malignant melanoma were identified. Out of 5 patients, 60% were females and 40% were male patients. Age of the patients ranged from 60-75 yrs. The commonest presenting symptom was blood with stools 60% of the patients. Most of the patients at the time of diagnosis had Stage III disease (60%) with nodal metastasis in all the patients. The commonest histological variant seen was epitheloid variant of malignant melanoma (3 cases).
Conclusion: Elderly patients presenting with non-specific symptoms like melena, mass prolapse, and abnormal bowel habits: malignant melanoma should always be kept as one of the differential diagnosis.
Key words: Melanoma, APR, Melena, IHC, WLE