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A rare case of recurrent primary anorectal melanoma emphasizing the importance of postoperative follow-ups

BACKGROUND: Primary anorectal melanoma can be a rare differential diagnosis of anorectal mass. Due to the low case number reported in the literature, physicians are not aware of this aggressive disease. Although no consensus exists, wide local excision and abdominoperineal resection are considered t...

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Autores principales: Li, Zhihao, Šandera, Peter, Beer, Marc, Weber, Markus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7140585/
https://www.ncbi.nlm.nih.gov/pubmed/32264858
http://dx.doi.org/10.1186/s12893-020-00727-6
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author Li, Zhihao
Šandera, Peter
Beer, Marc
Weber, Markus
author_facet Li, Zhihao
Šandera, Peter
Beer, Marc
Weber, Markus
author_sort Li, Zhihao
collection PubMed
description BACKGROUND: Primary anorectal melanoma can be a rare differential diagnosis of anorectal mass. Due to the low case number reported in the literature, physicians are not aware of this aggressive disease. Although no consensus exists, wide local excision and abdominoperineal resection are considered the mainstay therapy. CASE PRESENTATION: An 85-year-old female patient presented with fecal incontinence 5 years after local resection of a primary anorectal melanoma. In the rectoscopy, a tumor proximal to the dentate line was identified and later confirmed as a recurrent primary anorectal melanoma. There were no signs of locoregional or distant metastasis on the MRI and PET/CT. She underwent another wide local excision and regained fecal continence postoperatively. CONCLUSIONS: Primary anorectal melanoma should belong to the differential diagnosis of anorectal mass. If technically feasible, wide local excision represents a less invasive treatment than abdominoperineal resection, retaining the anal sphincter and patient’s quality of life. Even though wide local excision has a higher recurrence rate than abdominoperineal resection, there is no difference in survival between the two procedures. This is only under the premise that patients are followed-up regularly after wide local excision so that recurrence can be spotted early on and locally excised.
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spelling pubmed-71405852020-04-14 A rare case of recurrent primary anorectal melanoma emphasizing the importance of postoperative follow-ups Li, Zhihao Šandera, Peter Beer, Marc Weber, Markus BMC Surg Case Report BACKGROUND: Primary anorectal melanoma can be a rare differential diagnosis of anorectal mass. Due to the low case number reported in the literature, physicians are not aware of this aggressive disease. Although no consensus exists, wide local excision and abdominoperineal resection are considered the mainstay therapy. CASE PRESENTATION: An 85-year-old female patient presented with fecal incontinence 5 years after local resection of a primary anorectal melanoma. In the rectoscopy, a tumor proximal to the dentate line was identified and later confirmed as a recurrent primary anorectal melanoma. There were no signs of locoregional or distant metastasis on the MRI and PET/CT. She underwent another wide local excision and regained fecal continence postoperatively. CONCLUSIONS: Primary anorectal melanoma should belong to the differential diagnosis of anorectal mass. If technically feasible, wide local excision represents a less invasive treatment than abdominoperineal resection, retaining the anal sphincter and patient’s quality of life. Even though wide local excision has a higher recurrence rate than abdominoperineal resection, there is no difference in survival between the two procedures. This is only under the premise that patients are followed-up regularly after wide local excision so that recurrence can be spotted early on and locally excised. BioMed Central 2020-04-07 /pmc/articles/PMC7140585/ /pubmed/32264858 http://dx.doi.org/10.1186/s12893-020-00727-6 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Li, Zhihao
Šandera, Peter
Beer, Marc
Weber, Markus
A rare case of recurrent primary anorectal melanoma emphasizing the importance of postoperative follow-ups
title A rare case of recurrent primary anorectal melanoma emphasizing the importance of postoperative follow-ups
title_full A rare case of recurrent primary anorectal melanoma emphasizing the importance of postoperative follow-ups
title_fullStr A rare case of recurrent primary anorectal melanoma emphasizing the importance of postoperative follow-ups
title_full_unstemmed A rare case of recurrent primary anorectal melanoma emphasizing the importance of postoperative follow-ups
title_short A rare case of recurrent primary anorectal melanoma emphasizing the importance of postoperative follow-ups
title_sort rare case of recurrent primary anorectal melanoma emphasizing the importance of postoperative follow-ups
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7140585/
https://www.ncbi.nlm.nih.gov/pubmed/32264858
http://dx.doi.org/10.1186/s12893-020-00727-6
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