Debulking Operation, Radiation Therapy, and Sphincter-Sparing Local Wide Excision for The Lower Rectal Melanoma: A Case Report

Background Rectal melanoma is a rare disease that accounts for about 1% of rectal cancers. Abdominoperineal resection was the standard surgical intervention for local control. However, it can lead to complications and reduce the quality of life due to colostomy. Debulking surgery, radiotherapy (RT), and sphincter-sparing wide local excision (WLE) were performed on a patient with rectal melanoma.Case presentationA case of a 79-year-old woman with anal pain and bloody stool for 1 month was reported in this study. The digital examination of the rectum revealed a big polypoid mass over the lower rectum. Stage II rectal melanoma was diagnosed by colonoscopy, biopsy, magnetic resonance imaging, and positron emission tomography. The patient initially received debulking surgery to relieve the symptoms of active bleeding followed by radiotherapy for the residual tumor with partial response. Finally, a sphincter-sparing WLE was performed for the residual tumor to preserve the anal function. The postoperative course went smoothly. No local recurrence and anal symptoms were observed during the 2-years follow-up period.Conclusions: Combining debulking surgery, RT, and WLE may be a viable alternative for rectal melanoma that cannot be completely resected at the beginning and accompanied by bleeding symptoms.

Duodenal Metastasis From a Rectal Malignant Melanoma Primary: A Case Report

Duodenal melanoma constitutes a very small number of gastrointestinal malignant melanomas. The small intestine is a common site for the metastatic spread of cutaneous melanomas; however, its metastatic involvement from a primary rectal melanoma origin has seldom been reported. We present the histopathologic features of an unusual case of primary rectal melanoma metastasizing to the duodenum.

Primary rectal melanoma (a case report)

Primary rectal melanoma is a rare malignant tumor with an aggressive course and poor prognosis. The article describes a clinical observation demonstrating the successful comprehensive treatment of primary rectal melanoma. A patient with a complicated course of rectal melanoma, stage IV of the first stage was performed by surgical treatment with removal of the external intestine according to the Hartmann type with removal of the uterine appendages from both sides of the en-block, and resection of the left pelvic plexus. In the postoperative period, the patient underwent chemoembolization of the liver with combined immunotherapy. The patient is alive two years after the operation; there is no evidence for local recurrence and progression of the disease.

Ano-rectal Melanoma: A Rare Case Report

Ano-rectal melanoma is extremely rare and has dismal prognosis when compared to cutaneous melanomas. It presents as ano-rectal mass and patients usually complain of passing blood in stools. Being, a highly aggressive neoplasm, widespread metastasis is common, which can be seen even at the time of diagnosis. Here, we present a case report of ano-rectal melanoma in a 40-year old male, who presented with complaints of anal growth since one month. Initially, a clinical diagnosis of rectal carcinoma was suspected. However, biopsy of the growth showed histomorphological features of melanoma, which were confirmed on immunohistochemistry.