Coexistence of Anorectal Malignant Melanoma and Right Colon Metastatic Melanoma: A Case Report and Literature Review
EAES Academy. Salama M. 07/05/22; 363008; P051
Mr. Mohamed Salama
Contributions
Contributions
Abstract
Introduction
Anorectal malignant melanoma is an extremely rare, aggressive tumour with grave prognosis, accounting for 0.4-1.6% of all melanomas and 0.5-4.6% of anorectal malignant tumours. Moreover, coexistence of anorectal melanoma and right colon metastatic melanoma is rarer and not previously reported.
We report a case of anorectal malignant melanoma synchronous with right colon metastatic melanoma and metastatic right groin lymph node melanoma hoping our case can contribute to the existing literature.
Case report
A 77 year old male on a background of chronic kidney disease presented with lower abdominal pain for a week, associated with nausea, weight loss and anorexia. On examination, he was tender in the right iliac fossa and suprapubic region and there was a right groin mass, query femoral hernia/ lymph node. His laboratory findings reported CRP of 101, WCC 7.6, LDH 610, lactate 3.6, deranged Urea and creatinine and normal LFTs. CT abdomen and pelvis with contrast reported diffuse lymphadenopathy, bilateral adrenal masses and a soft tissue mass deep within the pelvis and perineum extending to involve the prostate, seminal vesicles, mesorectum fascia and rectum. Colonoscopy up to caecum showed an anorectal black ulcerative lesion along with a right colon ulcerating mass, which were biopsied and right groin lymph node was excised. Histology reported metastatic right groin lymph node melanoma and metastatic malignant melanoma of the right colon and anorectal malignant melanoma. Thorough physical examination revealed no other ocular or mucocutaneous lesions. The case was discussed at the Oncology MDT and referred for palliative chemotherapy.
Conclusion:
Synchronous anorectal melanoma and right colon melanoma is extremely rare and not reported previously. The right colon melanoma found in this case is thought to be a secondary rather than a primary. The presence of primary melanoma of the colon has been questionable since there are no melanocytes in the colon. GI melanoma is a challenging diagnostic entity that requires a thorough investigation to determine if it is a true primary lesion or metastatic.
Anorectal malignant melanoma is an extremely rare, aggressive tumour with grave prognosis, accounting for 0.4-1.6% of all melanomas and 0.5-4.6% of anorectal malignant tumours. Moreover, coexistence of anorectal melanoma and right colon metastatic melanoma is rarer and not previously reported.
We report a case of anorectal malignant melanoma synchronous with right colon metastatic melanoma and metastatic right groin lymph node melanoma hoping our case can contribute to the existing literature.
Case report
A 77 year old male on a background of chronic kidney disease presented with lower abdominal pain for a week, associated with nausea, weight loss and anorexia. On examination, he was tender in the right iliac fossa and suprapubic region and there was a right groin mass, query femoral hernia/ lymph node. His laboratory findings reported CRP of 101, WCC 7.6, LDH 610, lactate 3.6, deranged Urea and creatinine and normal LFTs. CT abdomen and pelvis with contrast reported diffuse lymphadenopathy, bilateral adrenal masses and a soft tissue mass deep within the pelvis and perineum extending to involve the prostate, seminal vesicles, mesorectum fascia and rectum. Colonoscopy up to caecum showed an anorectal black ulcerative lesion along with a right colon ulcerating mass, which were biopsied and right groin lymph node was excised. Histology reported metastatic right groin lymph node melanoma and metastatic malignant melanoma of the right colon and anorectal malignant melanoma. Thorough physical examination revealed no other ocular or mucocutaneous lesions. The case was discussed at the Oncology MDT and referred for palliative chemotherapy.
Conclusion:
Synchronous anorectal melanoma and right colon melanoma is extremely rare and not reported previously. The right colon melanoma found in this case is thought to be a secondary rather than a primary. The presence of primary melanoma of the colon has been questionable since there are no melanocytes in the colon. GI melanoma is a challenging diagnostic entity that requires a thorough investigation to determine if it is a true primary lesion or metastatic.
Introduction
Anorectal malignant melanoma is an extremely rare, aggressive tumour with grave prognosis, accounting for 0.4-1.6% of all melanomas and 0.5-4.6% of anorectal malignant tumours. Moreover, coexistence of anorectal melanoma and right colon metastatic melanoma is rarer and not previously reported.
We report a case of anorectal malignant melanoma synchronous with right colon metastatic melanoma and metastatic right groin lymph node melanoma hoping our case can contribute to the existing literature.
Case report
A 77 year old male on a background of chronic kidney disease presented with lower abdominal pain for a week, associated with nausea, weight loss and anorexia. On examination, he was tender in the right iliac fossa and suprapubic region and there was a right groin mass, query femoral hernia/ lymph node. His laboratory findings reported CRP of 101, WCC 7.6, LDH 610, lactate 3.6, deranged Urea and creatinine and normal LFTs. CT abdomen and pelvis with contrast reported diffuse lymphadenopathy, bilateral adrenal masses and a soft tissue mass deep within the pelvis and perineum extending to involve the prostate, seminal vesicles, mesorectum fascia and rectum. Colonoscopy up to caecum showed an anorectal black ulcerative lesion along with a right colon ulcerating mass, which were biopsied and right groin lymph node was excised. Histology reported metastatic right groin lymph node melanoma and metastatic malignant melanoma of the right colon and anorectal malignant melanoma. Thorough physical examination revealed no other ocular or mucocutaneous lesions. The case was discussed at the Oncology MDT and referred for palliative chemotherapy.
Conclusion:
Synchronous anorectal melanoma and right colon melanoma is extremely rare and not reported previously. The right colon melanoma found in this case is thought to be a secondary rather than a primary. The presence of primary melanoma of the colon has been questionable since there are no melanocytes in the colon. GI melanoma is a challenging diagnostic entity that requires a thorough investigation to determine if it is a true primary lesion or metastatic.
Anorectal malignant melanoma is an extremely rare, aggressive tumour with grave prognosis, accounting for 0.4-1.6% of all melanomas and 0.5-4.6% of anorectal malignant tumours. Moreover, coexistence of anorectal melanoma and right colon metastatic melanoma is rarer and not previously reported.
We report a case of anorectal malignant melanoma synchronous with right colon metastatic melanoma and metastatic right groin lymph node melanoma hoping our case can contribute to the existing literature.
Case report
A 77 year old male on a background of chronic kidney disease presented with lower abdominal pain for a week, associated with nausea, weight loss and anorexia. On examination, he was tender in the right iliac fossa and suprapubic region and there was a right groin mass, query femoral hernia/ lymph node. His laboratory findings reported CRP of 101, WCC 7.6, LDH 610, lactate 3.6, deranged Urea and creatinine and normal LFTs. CT abdomen and pelvis with contrast reported diffuse lymphadenopathy, bilateral adrenal masses and a soft tissue mass deep within the pelvis and perineum extending to involve the prostate, seminal vesicles, mesorectum fascia and rectum. Colonoscopy up to caecum showed an anorectal black ulcerative lesion along with a right colon ulcerating mass, which were biopsied and right groin lymph node was excised. Histology reported metastatic right groin lymph node melanoma and metastatic malignant melanoma of the right colon and anorectal malignant melanoma. Thorough physical examination revealed no other ocular or mucocutaneous lesions. The case was discussed at the Oncology MDT and referred for palliative chemotherapy.
Conclusion:
Synchronous anorectal melanoma and right colon melanoma is extremely rare and not reported previously. The right colon melanoma found in this case is thought to be a secondary rather than a primary. The presence of primary melanoma of the colon has been questionable since there are no melanocytes in the colon. GI melanoma is a challenging diagnostic entity that requires a thorough investigation to determine if it is a true primary lesion or metastatic.
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