Anorectal Malignant Melanoma, followed by Local Excision and Immunochemotherapy, which has Survived 3 and half Years without Any Sign of Recurrence

Akira Nakashima¹⁾³⁾, Masato Koseki¹⁾, Harumi Tominaga¹⁾, Akiko Katayama³⁾, Junichi Motoshita²⁾ and Kiyomi Taniyama²⁾

Department of Surgery¹⁾ and Department of Pathology²⁾, National Kure Medical Center
Department of Surgery, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University³⁾

Anorectal malignant melanoma, while rare, involves a dismal prognosis and lacks an established therapeutic regimen. We report a case treated with local excision and immunochemotherapy and showing no sign of recurrence in the 3.5 years since surgery. A 56-year-old woman with an anal tumor was found on physical examination to have a pedunculated polyp 20 mm in diameter on the anorectal wall and diagnosed histologically after biopsy as malignant melanoma. She underwent local excision. Pathological findings were malignant melanoma sm2, ly0, v0, ow (-), aw (-), ew (-). Following adjuvant immunochemotherapy, she has remained well without recurrence in the 3.5 years since surgery. We review cases of local excision in Japan, and propose local excision as a curative alternative in cases of pedunculated polyps 10 mm or less in diameter and penetrating to the submucosal layer but without ulcers.

Key words
anorectal, malignant melanoma, local excision

Reprint requests
Akira Nakashima
1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551 JAPAN

Accepted
March 26, 2008

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