Laparoscopic abdominoperineal resection with lateral lymph node dissection for anorectal melanoma: A case report

Abstract

Because anorectal melanoma, a rare cancer with a poor outcome, does not respond well to local radiation therapy or systemic chemotherapy, surgery is the primary treatment. Herein, we present a case of anorectal melanoma with lateral and inguinal lymph node metastases. A 61-year-old woman presented with rectal bleeding. Colonoscopy revealed a black tumor with ulceration in the anorectum. A CT scan revealed an anorectal tumor with left lateral lymph node swelling and right inguinal lymph node swelling. We performed a laparoscopic abdominoperineal resection with lateral lymph node dissection and right inguinal lymph node dissection. One year after the initial operation, pulmonary metastases were observed, and pulmonary resection was performed. After the pulmonary resection, brain metastases developed, and surgical resection was performed. Despite the recurrence of disease, the patient has survived for 52 months since the initial surgery and continues to receive systemic chemotherapy.

Clinical evidence, diagnostic approach and challenging therapeutic modalities for malignant melanoma of the anorectum

“…Therapeutic approach depends on clinical staging that includes computed tomography (CT), magnetic resonance imaging (MRI), endoscopic ultrasonography and positron emission tomography (PET)‐CT. Prognosis is adversely linked with the extent of lymph node metastasis and potential lymphovascular invasion 13 . Despite recent research on novel therapeutic strategies against ARMMs, surgical resection appears as the only potentially curative approach 14,15 .…”