Annals of Coloproctology

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Case Reports

Multiple gastrointestinal melanoma causing small bowel intussusception: Jian Yang Eng, Salehah Tahkin, Huzairi Yaacob, Nor Hayati Yunus, Ahmad Shan Wani Mohamed Sidek, Michael Pak-Kai Wong; Ann Coloproctol. 2023;39(1):85-88. Published online July 21, 2021; DOI: https://doi.org/10.3393/ac.2021.00143.0020

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A 61-year-old gentleman presented with small bowel intussusception from small bowel melanoma intussusceptum. He complains of intermittent abdominal distension but no history of intestinal obstruction. Apart from this, he was also symptomatic anemia which required repeated transfusion for the past few months. The contrast-enhanced computed tomography of the abdomen shows an omental mass with small bowel intussusception. He then underwent an exploratory laparotomy with segmental resection of the affected segment. Histopathological examination confirmed primary gastrointestinal melanoma. Multiple small bowel malignant melanoma is a rare disease. It remains a controversial diagnosis as it may be a primary or metastasis from an unidentified or regressed primary cutaneous melanoma. Prompt surgical intervention enables us to obtain tissue diagnosis, prevent complete intestinal obstruction and strategize the goals of treatment for the patient.

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Primary melanoma of the gastrointestinal tract
Paola De Nardi, Stefania Guida, Giuseppe Damiano, Nathalie Rizzo, Ana Maria Samanes Gajate, Silvia Teresa Riva, Giovanni Paolino, Michele Colombo, Roberta Tummineri, Franco Rongioletti, Santo Raffaele Mercuri, Arturo Chiti, Pierpaolo Sileri, Vincenzo Russ
World Journal of Gastroenterology.2026;[Epub] CrossRef
Small bowel melanoma causing obstruction: A case report and a literature review
Ammar Mattit, Ibrahim Marrawi, Safouh Kheir, Taha Khamis, Safaa Qatleesh, Muhammad Ali Ousta
International Journal of Surgery Case Reports.2024;[Epub] CrossRef
Epidemiology and outcomes of gastrointestinal mucosal melanomas: a national database analysis
Niraj James Shah, Mark M. Aloysius, Eldrin Bhanat, Shweta Gupta, Ganesh Aswath, Savio John, Shou-Jiang Tang, Hemant Goyal
BMC Gastroenterology.2022;[Epub] CrossRef

Malignant disease,Rare disease & stoma

Malignant Melanoma of Anorectum: Two Case Reports: Binh Van Pham, Jae Hyun Kang, Huynh Huu Phan, Min Soo Cho, Nam Kyu Kim; Ann Coloproctol. 2021;37(1):65-70. Published online February 28, 2021; DOI: https://doi.org/10.3393/ac.2020.01.07.1

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Abstract PDF

Malignant melanoma of the anorectum is a rare disorder. Patients often present with local symptoms similar to benign diseases. The prognosis is very poor, and almost all patients die because of metastases. We report 2 female patients with unremarkable histories. Both of them received previous operations before visiting our center after they were diagnosed with anorectal malignant melanoma. One case underwent abdominoperineal resection and postoperative chemotherapy. The other had been treated with ultralow anterior resection followed by immunotherapy.

Citations

Citations to this article as recorded by

Transanal sphincter-sparing local excision for primary anorectal malignant melanoma: a case report
Zhiting Wang, Jianwen Hu, Yingfeng Xu, Shiwei Chen
Frontiers in Oncology.2026;[Epub] CrossRef
Case Report: Surgical management and prognostic factors in primary anorectal melanoma: a retrospective analysis of nine cases
Xiangxiang Ren, Xiaoshi Jin, Tianhao Xie, Litao Liu, Qiang Wang, Xingli Sun, Meng Zhang
Frontiers in Medicine.2025;[Epub] CrossRef
Malignant melanoma of the anal canal: a case report
Shubu Parajuli, Shruti Sah, Narendra Pandit
Journal of Surgical Case Reports.2025;[Epub] CrossRef
A Rare Entity: Primary Malignant Melanoma of the Anorectum
Jeongmin Choi, Jong Whan Kim
Journal of Digestive Cancer Research.2024; 12(1): 44. CrossRef
Anorectal Malignant Melanoma Post- Hemorrhoidectomy
Ramazan Kozan, Ozkan Akpinar, Meral Toker
Acta Médica Portuguesa.2024; 37(7-8): 556. CrossRef
Immunotherapy for anorectal melanoma: A case report
Nicholas L. Vitagliano, Muhammad B. Darwish, Roger W. Hsiung
Current Problems in Cancer: Case Reports.2024; 15: 100302. CrossRef
Amelanotic Malignant Melanoma With Atypical Divergent Neuroendocrine Differentiation: A Report of an Unusual and Rare Case of Anorectal Bleeding
Shamiliprabha MG, Anand CD, Supriya Verma, Nivethitha S, Jaison J John
Cureus.2024;[Epub] CrossRef
Anorectal melanoma: systematic review of the current literature of an aggressive type of melanoma
Giovanni Paolino, Antonio Podo Brunetti, Carolina De Rosa, Carmen Cantisani, Franco Rongioletti, Andrea Carugno, Nicola Zerbinati, Mario Valenti, Domenico Mascagni, Giulio Tosti, Santo Raffaele Mercuri, Riccardo Pampena
Melanoma Research.2024; 34(6): 487. CrossRef
A rare account of incidentally discovered anal melanoma
Nawal Khan, Dondre Irving, Lynn O’Connor
Journal of Surgical Case Reports.2024;[Epub] CrossRef
Prolapsed anorectal malignant melanoma presenting as hemorrhoids
Busara Songtanin, Kenneth Nugent, Sameer Islam
Baylor University Medical Center Proceedings.2023; 36(1): 89. CrossRef
Long recurrence-free survival of localized rectal melanoma after abdominoperineal resection in comparison to partial excision and highlighting the place of immunotherapy: A case report
Othmane Bourouail, Noureddine Njoumi, Youssef Elmahdaouy, Mohamed Fahssi, Mbarek Yaka, Abderrahmane Hejjouji, Abdelmounaim Ait Ali
JRSM Open.2023;[Epub] CrossRef
Challenges in managing anorectal melanoma, a rare malignancy
Jyotirmoy Biswas, Lakshmi Deepak Bethineedi, Arkadeep Dhali, Jamal Miah, Sukanta Ray, Gopal Krishna Dhali
International Journal of Surgery Case Reports.2023;[Epub] CrossRef
Organ preservation in anorectal melanoma: A tempting challenge—a case report
Mohamed Mehdi Trabelsi, Neirouz Kammoun, Marwa Inoubli, Mohamed Ali Chaouch, Haifa Ben Romdhane, Wafa Koubaa, Hichem Jerraya
SAGE Open Medical Case Reports.2023;[Epub] CrossRef
Primary anorectal amelanotic melanoma with liver, lungs and lymph nodal metastases
James R Marak, Gaurav Raj, Shivam Dwivedi, Ariba Zaidi
BMJ Case Reports.2023; 16(11): e257510. CrossRef
Treatment of Hemorrhoid in Unusual Condition-Pregnancy
Hyo Seon Ryu
The Ewha Medical Journal.2022;[Epub] CrossRef

Synchronous Primary Anorectal Melanoma and Sigmoid Adenocarcinoma: Inju Cho, Kyung Jong Kim, Sung-Chul Lim; Ann Coloproctol. 2016;32(5):190-194. Published online October 31, 2016; DOI: https://doi.org/10.3393/ac.2016.32.5.190

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2 Web of Science
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Abstract PDF

A primary anorectal malignant melanoma is a rare tumor. Moreover, cases involving a synchronous anorectal melanoma and colon adenocarcinoma are extremely rare. The authors report a case of a synchronous anorectal melanoma and sigmoid adenocarcinoma in an 84-year-old man. The regions of the anorectal melanoma showed melanocytic nevi in the adjacent mucosa of the anal canal and rectum. A dysplastic nevus was also identified in the anal mucosa. This case demonstrates that an anorectal melanoma can arise from pre-existing anorectal melanocytic lesions.

Citations

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Anorectal melanoma: systematic review of the current literature of an aggressive type of melanoma
Giovanni Paolino, Antonio Podo Brunetti, Carolina De Rosa, Carmen Cantisani, Franco Rongioletti, Andrea Carugno, Nicola Zerbinati, Mario Valenti, Domenico Mascagni, Giulio Tosti, Santo Raffaele Mercuri, Riccardo Pampena
Melanoma Research.2024; 34(6): 487. CrossRef
Endoscopic diagnosis of gastrointestinal melanoma
Sheng Wang, Siyu Sun, Xiang Liu, Nan Ge, Guoxin Wang, Jintao Guo, Wen Liu, Jinlong Hu
Scandinavian Journal of Gastroenterology.2020; 55(3): 330. CrossRef

Original Articles

Treatment Outcomes of Anorectal Melanoma: Byung Min Choi, Hyoung Ran Kim, Hae-Ran Yun, Seung Ho Choi, Yong Beom Cho, Hee Cheol Kim, Seong Hyeon Yun, Woo Yong Lee, Ho-Kyung Chun; J Korean Soc Coloproctol. 2011;27(1):27-30. Published online February 28, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.1.27

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20 Citations

Abstract PDF

Purpose

An anorectal melanoma (AM) is a very rare tumor. However, sufficient data supporting effective surgical options for the disease do not exist. This retrospective review aimed to analyze treatment outcomes for an AM.

Methods

From June 1999 to December 2008, we retrospectively reviewed a prospectively collected consecutive series of 19 patients who had undergone a surgical resection for an AM at a single institute. Surgical method and clinicopathological factors were analyzed.

Results

The median age was 61.4 years (range, 46 to79 years). Main symptoms were an anal mass, hematochezia, perianal pain, tenesmus, fecal incontinence, and bowel habit change. The average duration of symptoms before diagnosis was 7.8 months (range, 1 to 36 months). S-100 and HMB-45 were positive in all patients, even in non-melanin pigmentation. There were 12 abdominoperineal resections (APRs) and 7 wide local excisions (WEs). The APR showed longer overall survival when compared with the WE (64.1 months vs. 10.9 months, P < 0.001). No patients who underwent a WE survived more than 13 months.

Conclusion

A high index of suspicion is necessary to establish the diagnosis for an AM in patients with anal symptoms, and S-100 and HMB-45 can be useful markers for an AM. Even with the small number of cases and the short follow-up, our data suggest that an APR for an AM may provide longer survival than a WE.

Citations

Citations to this article as recorded by

Prognostic Risk Factors and Construction of a Survival Prognostic Model for Anorectal Malignant Melanoma Based on the Surveillance, Epidemiology, and End Results Database
Jingchao Wang, Yi Bai, Fengqin Xu, Bochao Zhao, Yuanfei Shan, Zhijun Tan, Yamin Zhang
Indian Journal of Surgery.2026;[Epub] CrossRef
Clinical and pathological characteristics and correlation analysis of anorectal malignant melanoma
Lei Xi, Jinxing Zhou, Yan Wu, Boya Zhai, Rong Rong
Medicine.2025; 104(51): e46741. CrossRef
Optimal surgical management strategy for treatment of primary anorectal malignant melanoma—a systematic review and meta-analysis
Hugo C. Temperley, Niall J. O’Sullivan, Alan Keyes, Dara O. Kavanagh, John O. Larkin, Brian J. Mehigan, Paul H. McCormick, Michael E. Kelly
Langenbeck's Archives of Surgery.2022; 407(8): 3193. CrossRef
Trends in the management of anorectal melanoma: A multi-institutional retrospective study and review of the world literature
Josh Bleicher, Jessica N Cohan, Lyen C Huang, William Peche, T Bartley Pickron, Courtney L Scaife, Tawnya L Bowles, John R Hyngstrom, Elliot A Asare
World Journal of Gastroenterology.2021; 27(3): 267. CrossRef
Survival following surgical treatment for anorectal melanoma seems similar for local excision and extensive resection regardless of nodal involvement
E. Jutten, S. Kruijff, A.B. Francken, H.L. van Westreenen, K.P. Wevers
Surgical Oncology.2021; 37: 101558. CrossRef
Response to Kahlke et al
Audrius Dulskas
Colorectal Disease.2021; 23(11): 3029. CrossRef
Three Cases of Anorectal Malignant Melanoma Treated with Laparoscopic Abdominoperineal Resection
Shin Yoshida, Nobuaki Suzuki, Shinobu Tomochika, Yoshitaro Shindo, Yukio Tokumitsu, Michihisa Iida, Shigeru Takeda, Tatsuya Ioka, Shoichi Hazama, Tsuzuri Shirahama, Hiroo Kawano, Eiji Ikeda, Hiroaki Nagano
The Japanese Journal of Gastroenterological Surgery.2021; 54(9): 644. CrossRef
Spectrum of presentation in primary anorectal malignant melanoma and its management
Barun Kumar Singh, Samrat Ray, Shashi Dhawan, Samiran Nundy
BMJ Case Reports.2021; 14(10): e245449. CrossRef
Surgical treatment of anorectal melanoma: a systematic review and meta-analysis
Esther Jutten, Schelto Kruijff, Anne Brecht Francken, Martijn F Lutke Holzik, Barbara L van Leeuwen, Henderik L van Westreenen, Kevin P Wevers
BJS Open.2021;[Epub] CrossRef
Long-term Oncologic Outcome and Its Relevant Factors in Anal Cancer in Korea: A Nationwide Data Analysis
Hyuk Hur, Kyu-Won Jung, Byung-Woo Kim, Chang-Mo Oh, Young-Joo Won, Jae Hwan Oh, Nam Kyu Kim
Annals of Coloproctology.2020; 36(1): 35. CrossRef
Primary anorectal malignant melanoma with laparoscopic abdominoperineal resection: a case study and review of the relevant literature
Kentaro Nonaka, Kensuke Kudou, Shun Sasaki, Tomoko Jogo, Kosuke Hirose, Yuta Kasagi, Qingjiang Hu, Yasuo Tsuda, Yuichi Hisamatsu, Koji Ando, Yuichiro Nakashima, Hiroshi Saeki, Eiji Oki, Mitsuo Kamori, Masaki Mori
International Cancer Conference Journal.2020; 9(3): 116. CrossRef
Less is more: A systematic review and meta-analysis of the outcomes of radical versus conservative primary resection in anorectal melanoma
Henry G. Smith, Jessica Glen, Nancy Turnbull, Howard Peach, Ruth Board, Miranda Payne, Martin Gore, Karen Nugent, Myles J.F. Smith
European Journal of Cancer.2020; 135: 113. CrossRef
Anorectal Malignant Melanoma: Retrospective Analysis of Six Patients and Review of the Literature
Ibrahim Atak
Prague Medical Report.2018; 119(2-3): 97. CrossRef
Extensive surgery and lymphadenectomy do not improve survival in primary melanoma of the anorectum: results from analysis of a large database (SEER)
A. Ciarrocchi, R. Pietroletti, F. Carlei, G. Amicucci
Colorectal Disease.2017; 19(2): 158. CrossRef
Das anorektale maligne Melanom
T. R. Glowka, M. D. Keyver-Paik, T. Thiesler, J. Landsberg, J. C. Kalff, D. Pantelis
Der Chirurg.2016; 87(9): 768. CrossRef
Abdominoperineal Resection Provides Better Local Control But Equivalent Overall Survival to Local Excision of Anorectal Malignant Melanoma
Akihisa Matsuda, Masao Miyashita, Satoshi Matsumoto, Goro Takahashi, Takeshi Matsutani, Takeshi Yamada, Taro Kishi, Eiji Uchida
Annals of Surgery.2015; 261(4): 670. CrossRef
Anorectal malignant melanoma: retrospective analysis of management and outcome in a single Portuguese Institution
Isália Miguel, João Freire, Maria José Passos, António Moreira
Medical Oncology.2015;[Epub] CrossRef
Characteristics and Survival of Korean Anal Cancer From the Korea Central Cancer Registry Data
Hyoung-Chul Park, Kyu-Won Jung, Byung-Woo Kim, Aesun Shin, Young-Joo Won, Jae Hwan Oh, Seung-Yong Jeong, Chang Sik Yu, Bong Hwa Lee
Annals of Coloproctology.2013; 29(5): 182. CrossRef
Incidence and Survival Patterns of Rare Anal Canal Neoplasms Using the Surveillance Epidemiology and End Results Registry
Cristina Metildi, Elisabeth C. McLemore, Thuy Tran, David Chang, Bard Cosman, Sonia L. Ramamoorthy, Sidney L. Saltzstein, Georgia Robins Sadler
The American Surgeon™.2013; 79(10): 1068. CrossRef
Rectal melanoma
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Malignant Melanoma of the Anorectal Region.: Kim, Duck Woo , Kang, Sung Bum , Heo, Seung Chul , Park, Kyu Joo , Bang, Yung Jue , Park, Jae Gahb; J Korean Soc Coloproctol. 2002;18(4):257-261.

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Abstract PDF: PURPOSE
Anorectal melanoma is an uncommon tumor that comprises less than 1% of all malignancies of the anorectum. Its epidemiologic features, and clinical characteristics have not been well studied. We reviewed our experience in management of malignant melanoma of anorectal region.
METHODS
Eight patients with malignant melanoma of anorectal region were treated at Seoul National University Hospital in the period of 1980-2001. They represented 0.36% of the 2,246 patients with colorectal cancer seen at Seoul National University Hospital during the same period.
RESULTS
Five patients were female. The median age was 60 years. Common presenting symptoms were decreased stool caliber (63%), and anal bleeding (50%). All lesions developed at the area between 2cm and 7cm from anal verge and could be palpated on digital rectal examination. Two patients had multiple hepatic metastases at initial presentation. Of the remaining 6, abdominoperineal resection was performed for 4 patients, and local excision for 2. During the follow-up period with median length of 11 months, local recurrence occurred in 1 patient and distant metastases occurred in 3. Metastatic disease involved lung and/or brain. Five patients died during the follow-up period and the length of mean survival was 12 months.
CONCLUSION
Malignant melanoma of anorectum seems to have a poor prognosis with an appreciable incidence of regional node metastases. Common symptoms were similar to those of common anorectal disease. But all lesions were palpable on digital rectal examination. Increased awareness of this rare condition may lead to early detection and therefore to improved results.

Primary Malignant Melanoma of the Rectum.: Yoon, Seung Jae , Shin, Yong Woon , Jang, Cheol Soon , Cho, Byung Kwan , Cho, Yong Bum , Lee, Don , Kwon, Seong Ryul , Kim, Hyun Suk , Kwon, Kye Sook , Cho, Hyun Keun , Kim, Pum Soo , Kim, Young Soo , Kim, Kyung Rae , Min, Soo Kee; J Korean Soc Coloproctol. 2000;16(6):478-482.

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Abstract PDF: Malignant melanoma arising from the mucosal surface is a rare, virulent malignant neoplasm frequently associated with an extremely poor prognosis. The sites of initial presentation include the nose, oral cavity, larynx, vulva, vagina, anal canal and rectum. Primary melanoma of the rectum is extremely rare and its histogenesis is controversial. We present a case of primary malignant melanoma arising from the rectum in a 77-year-old woman who presented with intermittent anal bleeding for 2 months. Colonoscopic examination of the rectum revealed a 3.5 3.0 2.7 cm exophytic tumor with a granular surface in the rectum, 5cm from the anal verge. Black colored pigmentation was detected. Distant metastasis to liver was detected on abdominal CT scan. Light microscopy of tumor revealed malignant melanocytes surrounded by normal mucosa. The tumor cells reacted positively for immunohistochemical staining with S-100 protein and HMB-45. Clinical and laboratory examination excluded the presence of melanoma at sites other than rectum. Local excision of the tumor was performed.

Case Reports

Four Cases of Rectal Melanoma.: Chung, Bong Soo , Kim, Jin Cheon , Yu, Chang Sik , Lee, Han Il , Kim, Chang Nam; J Korean Soc Coloproctol. 1997;13(1):145-152.

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Abstract PDF: Although anal canal is the most common site for the development of malignant melanoma in the alimentary tract, it is extremely rare and melanoma can occur primarily at lower rectum. Anorectal melanoma constitutes 0.4% to 0.8% of colorectal malignancies and less than 2% of melanomas. The prognosis may depend on the extent of disease and depth of invasion. It generally seems to be very poor in spite of aggressive treatment. We have treated four patients of rectal melanomas out of 1,477 cases of all colorectal cancer between September, 1989 and January, 1997 ; a 39-year-old female with the intermittent blood-tinged stool, a 51-year-old male with hematochezia, a 59-year-old male with anal bleeding and a 65-year-old female with anal bleeding. They were treated by abdominoperineal resection with pelvic lymph node dissection and were confirmed histologically rectal melanomas.

Primary Melanoma of the Anorectum Report of Three Cases.: Park, Jng Hyun , Lee, Sang Kuon , Oh, Sung Taek , Kim, Se Kyung , Kim, In Chul; J Korean Soc Coloproctol. 2000;16(1):37-40.

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Abstract PDF: Primary melanoma of anorectum is a very rare, aggressive tumor with a reported 5-year survival rate of 6%. Over 90% of all anorectal melanomas arise at the dentate line, but primary lesions well above this line in the rectum or rectosigmoid have been reported. Surgical treatments of this virulent tumor have ranged from conservative approach, such as wide local excision to abdominoperineal resection (APR) with or without bilateral inguinal lymphadenectomy. When wide local excision was compared to APR in terms of survival, no significant difference was noted. However, five-year survivors had 2 mm thin lesion, and underwent radical surgery. We have experienced three cases of primary anorectal melanoma, two of which underwent radical surgery and survived 20 months and 6 months respectively. One patient had wide local excision, and survived 5 months. One of the three patient had von Recklinghausen disease with caf -au-lait spots and primary melanoma, which is probably one of the first reported case in the literature.

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