title: Melanoma of the rectum: a rare entity.
abstract: A 41-year-old man presented with a 6-mo history of changed defecation and rectal bleeding. A 3-cm polypoid tumor of the lower rectum was found at rectosigmoidoscopy, which proved to be a leiomyosarcoma upon biopsy. Dissemination studies did not show any metastases. He was underwent to an abdomino-perineal resection (APR). Histopathology of the specimen showed a melanoma (S-100 stain positive). Two years after the resection, metastases in the abdomen and right lung were found. He died one and half years later. Primary anorectal melanoma is a rare and very aggressive disorder. According to current data, one should always perform a S-100 stain when anorectal sarcoma is suspected. A positive S-100 stain suggests the tumour to be most likely a melanoma. Subsequently, thorough dissemination studies need to be performed. Depending on the outcome of the dissemination studies, a surgical resection has to be performed. Nowadays, a sphincter-saving local excision combined with adjuvant loco-regional radiotherapy should be preferred in case of small tumors. The same loco-regional control is achieved with less "loss of function" compared to non-sphincter saving surgery. Only in the case of large and obstructing tumors an abdomino-perineal resection is the treatment of choice.
authors.affiliation: Jeroen Bosch Hospital, Department of Surgery, 's-Hertogenbosch 5211, The Netherlands. pvanschaik@hotmail.com
authors.forename: P-M
authors.initials: PM
authors.lastname: van Schaik
authors.forename: M-F
authors.initials: MF
authors.lastname: Ernst
authors.forename: H-A
authors.initials: HA
authors.lastname: Meijer
authors.forename: K
authors.initials: K
authors.lastname: Bosscha
mesh_terms: D000328:Adult; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery; D011379:Prognosis; D012004:Rectal Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery; D009418:S100 Proteins / Q000378:metabolism
chemical_list: D009418:S100 Proteins