Clinicopathologic presentation and natural history of anorectal melanoma: A case series of 18 patients

Caitlin Hicks, Emmanouil P. Pappou, Jonathan T. Magruder, Benny Gazer, Sandy H Fang, Elizabeth C. Wick, Susan L Gearhart, Nita Ahuja, Jonathan Efron

Research output: Contribution to journalArticle

Abstract

Anorectal melanoma is a rare malignant neoplasm with variable natural history and nonspecific presentation. We describe the clinicopathologic and prognostic parameters of a series of 18 patients (16 [88.9%] white; 10 [55.6%] male; median age, 64.0 years [interquartile range, 45.8-74.3 years]) with histologically proven anorectal melanoma treated at our institution during a 21-year period between October 1991 and August 2012. Late diagnosis was common (44.5% of patients had stage II disease or worse at diagnosis), likely owing to a delay in presentation, nonspecific presenting symptoms, and frequent incorrect diagnoses (16 cases [88.9%]). Overall disease-specific mortality was 66.7% (12 of 18 patients), with a median time to death of 15.5 months (interquartile range, 7.3-25.5 months). Disease-specific survival was significantly better following wide local excision vs abdominoperineal resection (P = .04), although patients undergoing the former tended to have fewer rectal lesions (P = .04), smaller lesions (P = .02), and a trend toward less advanced stage (P = .06). Larger studies assessing optimal medical and surgical management for anorectal melanoma are needed to improve outcomes.

Original languageEnglish (US)
Pages (from-to)608-611
Number of pages4
JournalJAMA Surgery
Volume149
Issue number6
DOIs
StatePublished - 2014

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Melanoma
Delayed Diagnosis
Natural History
Survival
Mortality
Neoplasms

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

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Clinicopathologic presentation and natural history of anorectal melanoma : A case series of 18 patients. / Hicks, Caitlin; Pappou, Emmanouil P.; Magruder, Jonathan T.; Gazer, Benny; Fang, Sandy H; Wick, Elizabeth C.; Gearhart, Susan L; Ahuja, Nita; Efron, Jonathan.

In: JAMA Surgery, Vol. 149, No. 6, 2014, p. 608-611.

Research output: Contribution to journalArticle

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