ANAL MELANOMA IS RARE ITS SILENCE – DEADLY

Introduction and Importance: Anorectal mucosal melanoma (AMM) is an infrequent and highly aggressive form of mucosal melanoma. Its rarity makes it challenging to clinically diagnose, and its initial symptoms are typically nonspecific such as rectal/anal bleeding (the most common symptom), anal pain, or the presence of an anal mass.The prognosis for this condition is generally poor, and its incidence appears to be increasing each year. AMMs often go undetected and/or are already metastasized at the time of diagnosis.Case Presentation:We report a case of a 68-yearold male who presented with per rectal bleeding,breathlessness and loss of weight.clinical examination, Imaging ,radiological tests and pathological study revealed malignant melanoma. After preoperative optimization, the patient underwent successful laparoscopic antero perineal resection. Histopathology confirmed the diagnosis. Clinical Discussion:The most common clinical presentations of AM are changes in bowel habits, bowel obstruction, rectal bleeding, anal pain, and/or rectal tenesmus.These features are often associated with a mass that can prolapse through the anus Clinically,AMs are polypoid lesions,mostly ulcerated and not pigmented,with an irregular surface,sometimes showing black or brown spots. AM is often bloody and covered with mucinous/fibrinous material. The frequent amelanotic presentation of AM means that neoplasms of other origins, such as non-Hodgkin lymphoma, adenocarcinoma, and sarcoma, should be considered in the differential diagnosis Conclusion: The diagnosis of malignant melanoma,including anorectal melanoma,heavily relies on clinical examination.To address this we propose implementing full-body skin surveys with per rectal examination as part of physical examinations. Additionally, we recommend annual anoscopies with particular attention to the dentate line due to the aggressive nature of melanomas in the anorectal region.