Anal melanoma: a clinical challenge without therapeutic consensus

Anal melanoma is a rare malignancy, accounting for 0.4% to 1.6% of all melanomas. Its atypical presentation, low incidence, and non-specific symptoms make it a challenging diagnosis, which can lead to delayed treatment with an unfavorable impact on clinical outcomes. Treatment should be multidisciplinary and may include surgical resection with adjuvant therapy, chemotherapy, and radiotherapy. We present the case of a male patient who presented to the emergency department due to foreign body sensation and transanal bleeding. The patient underwent an anal exploration under anesthesia, where a hyperpigmented canal-dependent tumor lesion with extension into the perianal skin was found. After a wide local excision, histopathological study confirmed the diagnosis of invasive nodular melanoma. The patient was discharged without complications for follow-up and management in the outpatient medical oncology clinic.