title: Polypoid anal melanoma. A case report and review of the literature.
abstract: BACKGROUND
  Ano-rectal melanoma is an uncommon finding in patients complaining of rectal bleeding and/or anal mass often misinterpreted as a haemorroidal pile.
  
  
  METHODS
  A 55-years-old woman, complaining of rectal bleeding, frequent anal pain and anal mass suspected for haemorroidal thrombosis was referred for evaluation and possible treatment. A brown polypoid mass arising from the anal canal/lower rectum with a maximum diameter of 6 cm was diagnosed. The hystological examination of the neoplasm, transanally removed, revealed the presence of a polypoid melanoma partially involving the resection margin. Nor metastases nor limph-node involvement were found at the total-body CT scan and at a CT-PET. C-KIT examination was negative. Multidisciplinary evaluation recommended an abdominoperineal resection followed by an adjuvant chemotherapy as the only possible salvage treatment. To date the patient has refused it.
  
  
  CONCLUSIONS
  The delay in the diagnosis of an anal melanoma is well-known, bringing frequently to treat advanced stages of the disease that to date has no clear guidelines for the treatment.
  
  
  BACKGROUND
  Ano-rectal melanoma, Mucosal melanoma, Rectal bleeding.
authors.forename: Roberta
authors.initials: R
authors.lastname: Tutino
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Clerico
authors.forename: Alberto Realis
authors.initials: AR
authors.lastname: Luc
authors.forename: Gaetano
authors.initials: G
authors.lastname: Gallo
authors.forename: Mario
authors.initials: M
authors.lastname: Trompetto
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001005:Anus Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D003937:Diagnosis, Differential; D013505:Digestive System Surgical Procedures / Q000523:psychology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006484:Hemorrhoids / Q000175:diagnosis; D006801:Humans; D008545:Melanoma / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D012002:Rectal Diseases / Q000209:etiology; D016312:Treatment Refusal