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Case Reports
. 2006 Jun 7;12(21):3453-5.
doi: 10.3748/wjg.v12.i21.3453.

Synchronous anorectal melanoma

Drinko Balicevic  1 , Karla Tomic, Miroslav Bekavac-Beslin, Igor Kovacevic, August Mijic, Mladen Belicza, Bozo Kruslin
Affiliations
Case Reports

Synchronous anorectal melanoma

Drinko Balicevic et al. World J Gastroenterol. .

Abstract

Anorectal melanoma is a very rare tumor with poor prognosis. Rectal bleeding is the most frequent symptom and surgical treatment ranges from local excision to radical abdominoperineal resection. We report a case of a 75-years-old male patient who presented with a history of recurrent rectal bleeding, and whose histopathological diagnosis was melanoma. Macroscopically, we found two distinct tumors in anorectal region, 0.5 cm and 1.5 cm from dentate line. The first one was pedunculated, on a thin stalk, measuring 1 cm in greatest diameter, and the second one was sessile and nodular measuring up to 2.8 cm in largest diameter. Microscopic examination and immunohistochemical analysis of both tumors confirmed the diagnosis of melanoma. This case represents multiple synchronous primary melanoma of the anorectal region, with a possibility that one of the lesions is primary melanoma and the second one is a satellite lesion.

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Figures

Figure 1
Figure 1
A: Macroscopical appearance of anorectal region with two melanomas; B: Photomicrograph of rectal melanoma covered with columnar epithelium (HE, original magnification x 100); C: Photomicrograph of anal melanoma covered with squamous epithelium showing strongly positive immunostaining for HMB-45 (original magnification x 200).
Figure 2
Figure 2
DNA histograms. A: Smaller tumor with two aneuploid peaks: left peak-hypodiploid population with DNA index of 1.22; right peak-hyperdiploid population with DNA index of 2.22. Middle peak-the diploid population of non tumoral cells; B: Larger tumor with two aneuploid peaks: left peak-hypodiploid population with DNA index of 1.32; right peak-hyperdiploid population with DNA index of 2.33. Middle peak-the diploid population of non tumoral cells.
See this image and copyright information in PMC

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