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Case Reports
. 2021 Apr 28;14(4):e240621.
doi: 10.1136/bcr-2020-240621.

Metastatic anorectal malignant melanoma causing ileocaecal junction obstruction due to contiguous spread

Swanit Hemant Deshpande  1 , Vishal Narkhede  1 , Sai Krishna Eswaravaka  2 , Jayashri Sanjay Pandya  3
Affiliations
Case Reports

Metastatic anorectal malignant melanoma causing ileocaecal junction obstruction due to contiguous spread

Swanit Hemant Deshpande et al. BMJ Case Rep. .

Abstract

Malignant melanoma of the anal canal is a rare and aggressive tumour associated with significant mortality. Early diagnosis and early curative surgical resection have shown to offer a survival advantage. We present a case of 53-year-old woman, who was accidentally diagnosed to have a localised lesion of malignant melanoma of the anal canal on histopathology report of the specimen of haemorrhoidectomy done for thrombosed external haemorrhoids. She refused any form of treatment and did not return for follow-up. Two years after the initial diagnosis, she presented with intestinal obstruction. The malignant melanoma had become advanced with multiple metastases to the lungs, the liver, the peritoneum and the spine. The patient underwent a diverting loop ileostomy. At the time of surgery, it was found that the primary malignant melanoma of anal canal had contiguously involved the entire large intestine up to the ileocaecal junction and hence transverse colostomy could not be done.

Keywords: dermatology; oncology; palliative care; surgery.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Image comparing the current FDG-PET scan report (left) to the initial report (right). The multiple metabolically active distal metastases are showcased in the current scan.
Figure 2
Figure 2
Melanotic greater omentum delivered out from the transverse skin incision made for the transverse colostomy, demonstrating the peritoneal deposits of the malignant melanoma of the anal canal.
Figure 3
Figure 3
Intraoperative picture depicting the terminal ileum loops being delivered out of the surgical wound and the melanotic IC junction marked by the arrow. IC, ileocaecal.
Figure 4
Figure 4
Intraoperative image with ileum loops delivered out of the surgical wound. The ileum appears to be normal and the mesentery shows melanotic deposits.
See this image and copyright information in PMC

References

    1. Stefanou A, Nalamati SPM. Anorectal melanoma. Clin Colon Rectal Surg 2011;24:171–6. 10.1055/s-0031-1286001 - DOI - PMC - PubMed
    1. Ramakrishnan AS, Mahajan V, Kannan R. Optimizing local control in anorectal melanoma. Indian J Cancer 2008;45:13–19. 10.4103/0019-509X.40641 - DOI - PubMed
    1. Singer M, Mutch MG. Anal melanoma. Clin Colon Rectal Surg 2006;19:078–87. 10.1055/s-2006-942348 - DOI - PMC - PubMed
    1. Kumar U, Singhal U. Anorectal melanoma: an unusual cause of rectal bleeding. J Clin Diagn Res 2017;11:ED12–13. 10.7860/JCDR/2017/30689.10641 - DOI - PMC - PubMed
    1. Khan M, Bucher N, Elhassan A, et al. . Primary anorectal melanoma. Case Rep Oncol 2014;7:164–70. 10.1159/000360814 - DOI - PMC - PubMed

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