Primary anorectal melanoma: Multimodality management in a series of four cases and review of literature

Anorectal melanoma is a very rare and aggressive mucosal melanocytic malignancy, accounting for 1% of all anorectal cancers. There have only been a few cases reported. Surgical resection remains the mainstay of treatment. No definitive management strategies exist because of the absence of randomized...

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Main Authors: Nishant Lohia, Manoj Prashar, S Harish, Sankalp Singh, Anand Subramananiam, Sundaram Viswanath, Richa Ranjan, Gaurav Trivedi
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2020-01-01
Series:Muller Journal of Medical Sciences and Research
Subjects:
Online Access:http://www.mjmsr.net/article.asp?issn=0975-9727;year=2020;volume=11;issue=2;spage=91;epage=95;aulast=Lohia
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author Nishant Lohia
Manoj Prashar
S Harish
Sankalp Singh
Anand Subramananiam
Sundaram Viswanath
Richa Ranjan
Gaurav Trivedi
author_facet Nishant Lohia
Manoj Prashar
S Harish
Sankalp Singh
Anand Subramananiam
Sundaram Viswanath
Richa Ranjan
Gaurav Trivedi
author_sort Nishant Lohia
collection DOAJ
description Anorectal melanoma is a very rare and aggressive mucosal melanocytic malignancy, accounting for 1% of all anorectal cancers. There have only been a few cases reported. Surgical resection remains the mainstay of treatment. No definitive management strategies exist because of the absence of randomized trials. We here report a case series on four cases of anorectal melanoma. All four cases underwent abdominoperineal resection (APR) and nodal dissection. Two out of four cases received adjuvant temozolomide (TMZ), one case received adjuvant doublet chemotherapy with TMZ and cisplatin, and the fourth case succumbed to nononcological disease before he could be subjected to adjuvant chemotherapy. In the first and third case, nodal dissection was limited to pelvic nodes only. However, in the second case, extensive nodal dissection in the form of bilateral pelvic and inguinal lymph nodal dissection and para-aortic lymph nodal dissection was performed. The fourth case also was subjected to extensive nodal dissection in form of bilateral pelvic and para-aortic lymph node dissection. The first patient however became metastatic at the end of first cycle of adjuvant TMZ and succumbed to his illness post 3 months of surgery. The second patient could complete all six cycles of adjuvant TMZ, and after 1 year of completion of adjuvant TMZ, he presented with skeletal and brain metastases. He also received palliative whole-brain radiotherapy for brain metastases. He finally succumbed to his disease 18 months after surgery. The third case completed all six cycles of adjuvant TMZ and is still alive with disease-free interval of around 1 year. The fourth case succumbed to nononcological death around 1 month after surgery.
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spelling doaj.art-5b7f5764e85d4494b25b5507872f87602022-12-21T20:11:58ZengWolters Kluwer Medknow PublicationsMuller Journal of Medical Sciences and Research0975-97272020-01-01112919510.4103/mjmsr.mjmsr_37_20Primary anorectal melanoma: Multimodality management in a series of four cases and review of literatureNishant LohiaManoj PrasharS HarishSankalp SinghAnand SubramananiamSundaram ViswanathRicha RanjanGaurav TrivediAnorectal melanoma is a very rare and aggressive mucosal melanocytic malignancy, accounting for 1% of all anorectal cancers. There have only been a few cases reported. Surgical resection remains the mainstay of treatment. No definitive management strategies exist because of the absence of randomized trials. We here report a case series on four cases of anorectal melanoma. All four cases underwent abdominoperineal resection (APR) and nodal dissection. Two out of four cases received adjuvant temozolomide (TMZ), one case received adjuvant doublet chemotherapy with TMZ and cisplatin, and the fourth case succumbed to nononcological disease before he could be subjected to adjuvant chemotherapy. In the first and third case, nodal dissection was limited to pelvic nodes only. However, in the second case, extensive nodal dissection in the form of bilateral pelvic and inguinal lymph nodal dissection and para-aortic lymph nodal dissection was performed. The fourth case also was subjected to extensive nodal dissection in form of bilateral pelvic and para-aortic lymph node dissection. The first patient however became metastatic at the end of first cycle of adjuvant TMZ and succumbed to his illness post 3 months of surgery. The second patient could complete all six cycles of adjuvant TMZ, and after 1 year of completion of adjuvant TMZ, he presented with skeletal and brain metastases. He also received palliative whole-brain radiotherapy for brain metastases. He finally succumbed to his disease 18 months after surgery. The third case completed all six cycles of adjuvant TMZ and is still alive with disease-free interval of around 1 year. The fourth case succumbed to nononcological death around 1 month after surgery.http://www.mjmsr.net/article.asp?issn=0975-9727;year=2020;volume=11;issue=2;spage=91;epage=95;aulast=Lohiaabdominoperineal resectionanorectummelanomatemozolomide
spellingShingle Nishant Lohia
Manoj Prashar
S Harish
Sankalp Singh
Anand Subramananiam
Sundaram Viswanath
Richa Ranjan
Gaurav Trivedi
Primary anorectal melanoma: Multimodality management in a series of four cases and review of literature
Muller Journal of Medical Sciences and Research
abdominoperineal resection
anorectum
melanoma
temozolomide
title Primary anorectal melanoma: Multimodality management in a series of four cases and review of literature
title_full Primary anorectal melanoma: Multimodality management in a series of four cases and review of literature
title_fullStr Primary anorectal melanoma: Multimodality management in a series of four cases and review of literature
title_full_unstemmed Primary anorectal melanoma: Multimodality management in a series of four cases and review of literature
title_short Primary anorectal melanoma: Multimodality management in a series of four cases and review of literature
title_sort primary anorectal melanoma multimodality management in a series of four cases and review of literature
topic abdominoperineal resection
anorectum
melanoma
temozolomide
url http://www.mjmsr.net/article.asp?issn=0975-9727;year=2020;volume=11;issue=2;spage=91;epage=95;aulast=Lohia
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AT sundaramviswanath primaryanorectalmelanomamultimodalitymanagementinaseriesoffourcasesandreviewofliterature
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