Primary anorectal melanoma is a rare and very aggressive disorder. A report published on March 14, 2008, in the World Journal of Gastroenterology addresses such a case. A 41-year-old man presented with a 6-month history of changed defecation and rectal bleeding. A 3-cm polypoid tumor of the lower rectum was found at rectosigmoidoscopy, which proved to be a leiomyosarcoma upon biopsy. Dissemination studies did not show any metastases. He underwent an APR. The histopathology of the specimen showed a melanoma (S-100 stain positive). Two years after the resection, metastases in the abdomen and right lung were found. He died a year and a half later.
In the view of the authors, if there is suspicion of an anorectal sarcoma, one should always perform an S-100 stain following a biopsy. A positive S-100 stain indicates that the tumor is most likely to be a melanoma. Depending on the outcome of the dissemination studies, a surgical resection has to be performed. It has been thought that a sphincter-saving local excision combined with adjuvant locoregional radiotherapy should be preferred in the case of small tumors. The same locoregional control is achieved with less loss of function compared to non-sphincter-saving surgery. Only in the case of large and obstructing tumors is an abdominoperineal resection the treatment of choice.
Reference: van Schaik PM, Ernst MF, Meijer HA, Bosscha K. Mela noma of the rectum: A rare entity. World J Gastroenterol 2008; 14(10): 1633-1635
Correspondence to: PM van Schaik, Jeroen Bosch Hospital, Nieuwstraat 34, NL 's-Hertogenbosch 5211, The Netherlands. firstname.lastname@example.org
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About World Journal of Gastroenterology
World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. The WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.
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