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Case Reports
. 2024 Sep 24;16(9):e70100.
doi: 10.7759/cureus.70100. eCollection 2024 Sep.

Primary Anorectal Mucosal Melanoma: A Unique Presentation of Mucosal Melanomas

Fatima Rezzoug  1   2 , Jihane Derfoufi  1   2 , Ouissam Al Jarroudi  1   2 , Sami Aziz Brahmi  1   2 , Said Afqir  1   2
Affiliations
Case Reports

Primary Anorectal Mucosal Melanoma: A Unique Presentation of Mucosal Melanomas

Fatima Rezzoug et al. Cureus. .

Abstract

Anorectal mucosal melanoma (AMM) is a rare and highly aggressive malignancy. It frequently presents with nonspecific symptoms, often resulting in delayed diagnosis and poor prognosis. This report describes the case of a 60-year-old male who presented with a painful para-anal papule that progressed to a fistula. Histopathological and immunohistochemical analyses confirmed AMM. Imaging revealed a locally advanced tumor without distant metastasis. Due to the locally advanced nature of the disease, a multidisciplinary team recommended neoadjuvant radiotherapy. This case highlights the diagnostic and therapeutic challenges associated with AMM and emphasizes the importance of a tailored, multidisciplinary approach. Surgical resection remains the cornerstone of treatment, with neoadjuvant therapy potentially improving surgical outcomes in advanced cases.

Keywords: anorectal malignancies; anorectal melanoma; case report; malignant melanoma; mucosal melanoma; treatment.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Histopathological and immunohistochemical examination of the tumor.
(A) Histopathological evaluation demonstrating malignant melanoma (hematoxylin and eosin, ×4). (B) immunohistochemistry staining showing positivity for S-100 protein. (C) immunohistochemistry staining showing positivity for Melan A. (D) immunohistochemistry staining showing positivity for human melanoma black-45.
Figure 2
Figure 2. Pelvic magnetic resonance imaging scan.
(A, B): coronal and sagittal images showing the presence of a circumferential, irregular, and asymmetrical tumor mostly on the left side of the lower rectum and anal area. The tumor was 51 mm thick and stretched over 10 cm.
See this image and copyright information in PMC

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