Anorectal melanoma, also known as anal melanoma, is a rare malignant neoplasm that arises from the anorectal mucosa. Anorectal melanoma is notably aggressive and is associated with a grim prognosis, often leading to fatal outcomes. Due to its anatomical position, Anorectal melanoma frequently manifests with symptoms such as rectal bleeding, a detectable mass, or altered bowel habits—symptoms that are also commonly seen in benign conditions like hemorrhoids, thereby contributing to diagnostic delays. This case highlights the diagnostic challenges of anal canal malignant melanoma, a rare and aggressive tumor often misdiagnosed as hemorrhoids. A 54-year-old female presented with an anal mass and intermittent rectal bleeding for eight months. On rectal examination, a large, polypoidal, pedunculated, and friable mass was identified on the right lateral surface of the anal canal, approximately 1.5 cm from the anal verge. Initial misdiagnosis delayed proper evaluation until a biopsy and PET scan suggested advanced, unresectable anorectal melanoma, later confirmed by histopathology and immunohistochemistry (HMB-45 and Melan-A positive). A palliative colostomy was performed for symptom relief. This case emphasizes the importance of early diagnosis in patients over 40 with rectal bleeding and anal masses, as timely evaluation can improve management and outcomes, and also notifies the early aggressiveness of the tumour. Timely intervention and individualized treatment strategies can help improve patient outcomes in this challenging condition.
Author
(s) Details
Umer
Hamid Wani
Department of Surgery, Rajiv Gandhi University of Health Sciences,
NIUM Hospital, Bangalore, Karnataka, India.
Kounser
Asharf
Department of Biochemistry, Govt. Medical College Srinagar, Jammu
& Kashmir, India.
Please see the book here:- https://doi.org/10.9734/bpi/aodhr/v2/5492
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