Primary anorectal malignant melanoma treated with neoadjuvant chemoradiotherapy and sphincter‑sparing surgery: A case report

Su,Meng; Zhu,Lucheng; Luo,Wenhua; Wei,Hangping; Zou,Changlin

doi:10.3892/ol.2014.1925

Primary anorectal malignant melanoma treated with neoadjuvant chemoradiotherapy and sphincter‑sparing surgery: A case report

Authors:
- Meng Su
- Lucheng Zhu
- Wenhua Luo
- Hangping Wei
- Changlin Zou
View Affiliations

Affiliations: Department of Radio‑Chemotherapy Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
Published online on: February 28, 2014 https://doi.org/10.3892/ol.2014.1925
Pages: 1605-1607

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Primary anorectal (PA) malignant melanoma (MM) is a rare disease associated with a high mortality rate. The most appropriate treatment strategy for PAMM remains controversial. A 55‑year‑old female patient, who was misdiagnosed with locally advanced rectal carcinoma, was treated with preoperative radiotherapy and concurrent oral capecitabine. During the therapy, grade 1 leukopenia occurred, however, there was no interruption to treatment. Following chemoradiotherapy, a computer tomography scan identified that the tumor had shrunk significantly and the original enlarged lymph nodes had disappeared. Eight weeks after completion of chemoradiotherapy, sphincter‑sparing surgery was performed on the patient and based on the postoperative pathological result, MM was diagnosed. At the time of writing, the patient has survived disease‑free for 15 months and at the most recent follow‑up examination the Karnofsky Performance Scale score was 100. The therapeutic regimen of neoadjuvant concurrent chemoradiotherapy together with sphincter‑sparing surgery is considered to be an optimal choice for patients with PAMM. However, further studies are required to evaluate the efficacy and clinical utility of this therapeutic regimen.

View Figures

View References

1	Wanebo HJ, Woodruff JM, Farr GH and Quan SH: Anorectal melanoma. Cancer. 47:1891–1900. 1981. View Article : Google Scholar : PubMed/NCBI
2	Pack GT and Oropeza R: A comparative study of melanoma and epidermoid carcinoma of the anal canal: A review of 20 melanomas and 29 epidermoid carcinomas (1930 to 1965). Dis Colon Rectum. 10:161–176. 1967. View Article : Google Scholar : PubMed/NCBI
3	Weston SD and Marren M: Malignant melanoma of the rectum. J Int Coll Surg. 17:403–416. 1952.PubMed/NCBI
4	Balch CM, Gershenwald JE, Soong SJ, et al: Final version of 2009 AJCC melanoma staging and classification. J Clin Oncol. 27:6199–6206. 2009. View Article : Google Scholar : PubMed/NCBI
5	Goldman S, Glimelius B and Påhlman L: Anorectal malignant melanoma in Sweden. Report of 49 patients. Dis Colon Rectum. 33:874–877. 1990. View Article : Google Scholar
6	Moore W: Recurrent melanoma of the rectum after previous removal from the verge of the anus in a man aged sixty-five. Lancet. 1:2901857.
7	Yap LB and Neary P: A comparison of wide local excision with abdominoperineal resection in anorectal melanoma. Melanoma Res. 14:147–150. 2004. View Article : Google Scholar : PubMed/NCBI
8	Konstadoulakis MM, Ricaniadis N, Walsh D and Karakousis CP: Malignant melanoma of the anorectal region. J Surg Oncol. 58:118–120. 1995. View Article : Google Scholar
9	Zhang S, Gao F and Wan D: Effect of misdiagnosis on the prognosis of anorectal malignant melanoma. J Cancer Res Clin Oncol. 136:1401–1405. 2010. View Article : Google Scholar : PubMed/NCBI
10	Thibault C, Sagar P, Nivatvongs S, Ilstrup DM and Wolff BG: Anorectal melanoma - an incurable disease? Dis Colon Rectum. 40:661–668. 1997. View Article : Google Scholar : PubMed/NCBI
11	Zhong J, Zhou JN, Xu FP and Shang JQ: Diagnosis and treatment of anorectal malignant melanoma - a report of 22 cases with literature review. Ai Zheng. 25:619–624. 2006.(In Chinese).
12	Slingluff CL Jr, Vollmer RT and Seigler HF: Anorectal melanoma: clinical characteristics and results of surgical management in twenty-four patients. Surgery. 107:1–9. 1990.
13	Cooper PH, Mills SE and Allen MS Jr: Malignant melanoma of the anus: report of 12 patients and analysis of 255 additional cases. Dis Colon Rectum. 25:693–703. 1982. View Article : Google Scholar : PubMed/NCBI
14	Phade VR and Lawrence WR: Anorectal melanoma. Br J Surg. 68:667–668. 1981. View Article : Google Scholar : PubMed/NCBI
15	Ballo MT, Gershenwald JE, Zagars GK, et al: Sphincter-sparing local excision and adjuvant radiation for anal-rectal melanoma. J Clin Oncol. 20:4555–4558. 2002. View Article : Google Scholar
16	Uner A, Kilic D, Mentes BB, Egehan I and Dursun A: Neoadjuvant radiotherapy in anorectal malignant melanoma. Int J Clin Pract. 57:65–67. 2003.PubMed/NCBI
17	Morton DL, Hsueh EC, Essner R, et al: Prolonged survival of patients receiving active immunotherapy with Canvaxin therapeutic polyvalent vaccine after complete resection of melanoma metastatic to regional lymph nodes. Ann Surg. 236:438–448. 2002. View Article : Google Scholar
18	Sanghera P, Wong DW, McConkey CC, Geh JI and Hartley A: Chemoradiotherapy for rectal cancer: an updated analysis of factors affecting pathological response. Clin Oncol (R Coll Radiol). 20:176–183. 2008. View Article : Google Scholar : PubMed/NCBI
19	Bujko K, Nowacki MP and Liszka-Dalecki P: Radiation therapy for anorectal melanoma - a report of three cases. Acta Oncol. 37:497–499. 1998. View Article : Google Scholar : PubMed/NCBI