UNVEILING THE REALITIES OF ANAL MELANOMA CARE IN A RESOURCE-CONSTRAINED SETTING

Authors

  • Pragya Mitra University College of Medical Sciences, Delhi-India
  • Deepak Kumar Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi-India
  • Anju Khairwa Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi-India
  • Aneeket Modak University College of Medical Sciences, Delhi-India https://orcid.org/0009-0008-0296-9110

DOI:

https://doi.org/10.55519/JAMC-04-12243

Keywords:

Malignant melanoma, Anorectal malignancy, HMB-45, Resource-poor-setting

Abstract

A 50-year-old lady presented with complaints of a progressively increasing anal mass and occasional bleeding per rectum for the past 4 months. Examination revealed an ulcero-proliferative growth in the anal canal, whose biopsy was suggestive of malignant melanoma. Inguinal lymph nodes, though enlarged, did not show evidence of malignant deposits on FNAC. Radiological investigations revealed a T3 lesion with no evidence of nodal metastasis. She underwent local excision of the mass with uneventful intraoperative and postoperative periods. The purpose of this report is to highlight the formidable challenges encountered in diagnosing this rare tumour, with potential implications for misdiagnosis, particularly within a resource-poor setting. This case highlights the importance of resource-appropriate approaches and surgical options available in a tertiary care hospital in North India.

Author Biographies

Pragya Mitra, University College of Medical Sciences, Delhi-India

 

Deepak Kumar, Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi-India

 

Anju Khairwa, Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi-India

 

Aneeket Modak, University College of Medical Sciences, Delhi-India

 

References

Chen H, Cai Y, Liu Y, He J, Hu Y, Xiao Q, et al. Incidence, Surgical Treatment, and Prognosis of Anorectal Melanoma From 1973 to 2011: A Population-Based SEER Analysis. Medicine (Baltimore) 2016;95(7):e2770.

Garg V, Rastogi S, Aswar H, Shamim SA, Dhamija E, Barwad A, et al. Clinicopathological profile and outcomes of anorectal melanoma from a tertiary care center in India. Future Sci OA 2022;8(4):FSO786.

Nigam JS, Nishit, Kumar T, Singh A, Tewari P, Pandey JK. Anorectal Melanoma-Brownish Black Mass Not Always a Hemorrhoid. J Gastrointest Cancer 2022;53(3):825–9.

Malaguarnera G, Madeddu R, Catania VE, Bertino G, Morelli L, Perrotta RE, et al. Anorectal mucosal melanoma. Oncotarget 2018;9(9):8785–800.

Charifa A, Zhang X. Morphologic and Immunohistochemical Characteristics of Anorectal Melanoma. Int J Surg Pathol 2018;26(8):725–9.

Satzger I, Küttler U, Völker B, Schenck F, Kapp A, Gutzmer R. Anal mucosal melanoma with KIT-activating mutation and response to imatinib therapy--case report and review of the literature. Dermatology 2010;220(1):77–81.

Singer M, Mutch MG. Anal Melanoma. Clin Colon Rectal Surg 2006;19(2):78–87.

Row D, Weiser MR. Anorectal Melanoma. Clin Colon Rectal Surg 2009;22(2):120–6.

Bajpai J, Abraham G, Saklani AP, Agarwal A, Das S, Chatterjee A, et al. Demographics, Pattern of Care, and Outcome Analysis of Malignant Melanomas - Experience From a Tertiary Cancer Centre in India. Front Oncol 2021;11:710585.

Matsuda A, Miyashita M, Matsumoto S, Takahashi G, Matsutani T, Yamada T, et al. Abdominoperineal resection provides better local control but equivalent overall survival to local excision of anorectal malignant melanoma: a systematic review. Ann Surg 2015;261(4):670–7.

Tien HY, McMasters KM, Edwards MJ, Chao C. Sentinel lymph node metastasis in anal melanoma: a case report. Int J Gastrointest Cancer 2002;32(1):53–6.

Olsha O, Mintz A, Gimon Z, Gold Deutch R, Rabin I, Halevy A, et al. Anal melanoma in the era of sentinel lymph node mapping: a diagnostic and therapeutic challenge. Tech Coloproctol 2005;9(1):60–2.

Stoidis CN, Spyropoulos BG, Misiakos EP, Fountzilas CK, Paraskeva PP, Fotiadis CI. Diffuse anorectal melanoma; review of the current diagnostic and treatment aspects based on a case report. World J Surg Oncol 2009;7:64.

Additional Files

Published

2023-12-23