title: A case series of anal melanoma including the results of treatment with imatinib in selected patients.
abstract: OBJECTIVE
  Anal melanoma is a rare malignancy with a poor prognosis.
  
  
  METHODS
  All patients with a diagnosis of anal melanoma treated at a single institution between 2000 and 2012 were identified and their treatment and outcome were evaluated.
  
  
  RESULTS
  Sixteen patients had a median survival of 2.9 years. Fourteen had Stage I or II disease with a median survival of 4.0 years and progression-free survival of 1.5 years. When used for disease staging, whole body positron emission tomography/CT identified an additional three sites of metastasis in five patients compared with CT of the chest, abdomen and pelvis. Surgery involved wide local excision or abdominoperineal excision with respective local recurrence rates of 50% and 66%. Eleven patients underwent testing for c-Kit mutations, of whom five were positive. Four of these were treated with the tyrosine kinase inhibitor imatinib, and showed rapid response of metastases outside the central nervous system.
  
  
  CONCLUSIONS
  The outcome of this malignancy remains poor. PET is the modality of choice for disease staging. Testing tumours for c-Kit mutations may allow selected patients to participate in trials of tyrosine kinase inhibitors.
authors.affiliation: Department of Colorectal Surgery, Royal Free Hospital, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Knowles
authors.affiliation: Department of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia.
authors.forename: A C
authors.initials: AC
authors.lastname: Lynch
authors.affiliation: Department of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia.
authors.forename: S K
authors.initials: SK
authors.lastname: Warrier
authors.affiliation: Department of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Henderson
authors.affiliation: Department of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia.
authors.forename: A G
authors.initials: AG
authors.lastname: Heriot
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000473:pathology / Q000601:surgery*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001005:Anus Neoplasms / Q000235:genetics / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D003606:Dacarbazine / Q000627:therapeutic use; D013505:Digestive System Surgical Procedures; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D000068877:Imatinib Mesylate / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008297:Male; D008545:Melanoma / Q000235:genetics / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D009154:Mutation; D009367:Neoplasm Staging; D009536:Niacinamide / Q000031:analogs & derivatives / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000627:therapeutic use; D019009:Proto-Oncogene Proteins c-kit / Q000235:genetics; D012189:Retrospective Studies; D000077157:Sorafenib; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D009536:Niacinamide; D003606:Dacarbazine; D000068877:Imatinib Mesylate; D000077157:Sorafenib; D019009:Proto-Oncogene Proteins c-kit
keywords: Anal melanoma; anal cancer; c-Kit; imatinib