Rectal Melanocarcinoma in an Elderly: A Case Report

Rectal melanocarcinoma is a rare and aggressive malignancy often misdiagnosed due to non specific presentation. Hereby the authors present a case of a 71-year-old male who presented with mild anal pain and occasional bleeding, along with a 3 cm protruding mass from the anal canal. Clinical examination identified thrombosed external haemorrhoids and a suspicious 2 cm mass. Routine blood tests and Echocardiography (ECG) were unremarkable, but proctoscopic examination confirmed the presence of the mass, which was surgically excised. Histopathological analysis of the excised tissue revealed spindle and polygonal cells with prominent macronucleoli and melanin pigment in the cytoplasm, particularly at the squamocolumnar junction. Microscopic examination at various magnifications supported the diagnosis of rectal melanocarcinoma. Despite surgical intervention, the prognosis for rectal melanocarcinoma remains poor due to its aggressive nature and high potential for metastasis. The present case underscores the critical importance of early recognition and thorough histopathological evaluation of atypical anorectal lesions to avoid misdiagnosis.