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

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

Research output: Contribution to journalArticlepeer-review

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 - Jun 2014

ASJC Scopus subject areas

  • Surgery

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