A Case of the Long-Term Survivor of Anorectal Melanoma after Local Excision

Toru Saito¹⁾²⁾, Ikuo Udagawa¹⁾, Shrestha Ram Dhoj¹⁾, Shigeki Watanabe¹⁾, Kazuyasu Shinmura¹⁾, Norio Kikuchi¹⁾ and Masaru Miyazaki²⁾

Department of Surgery, Sosa Municipal Hospital¹⁾
Department of General Surgery, Graduate School of Medicine, Chiba University²⁾

Anorectal malignant melanoma (MM) is a rare disease with a poor prognosis and early-phase metastasis. We report our successful treatment with local excision and chemotherapy that has enabled our patient to survive for 10 years. A 70-year-old man suffering from rectal polyps underwent local transanal excision. A pedunculated polyp about 20 mm long was resected. The cutting plane was black. The pathological diagnosis was MM. Some papers have reported that no difference exists in survival between abdominoperineal resection (APR) and local excision, with the patient followed up by chemotherapy alone. We have conducted CDV chemotherapy in our patient two or three times a year for 10 years. Anorectal MM has not been established despite the poor prognosis. Most cases of APR over these ten years have involved only local excision in this case. Lung metastasis detected in the ninth year has not progressed. In the tenth year, local recurrence was detected and local transanal excision was done, CDV chemotherapy was continued, and our patient remains free from disease and maintains high quality of life. This successfully case of ongoing anorectal MM provides valuable information on establishing an effective therapeutic regimen for this disease.

Key words
anorectal malignant melanoma, long time survival, local excision

Reprint requests
Toru Saito Department of General Surgery, Graduate School of Medicine, Chiba University
1-8-1 Inohana, Chuo-ku, Chiba, 260-8670 JAPAN

Accepted
January 31, 2007

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