@article{cavazzoni2015primary,
  title = {Primary Malignant Melanoma of the Rectum: Long-Term Disease-Free Survival Following Abdomino-Perineal Resection},
  author = {Emanuel Cavazzoni and Walter Bugiantella and Luigina Graziosi and Emanuele Rosati and Annibale Donini},
  year = 2015,
  url = {https://ibimapublishing.com/articles/GAST/2015/999601/},
  journal = {International Journal of Gastroenterology Research and Practice},
  volume = 2015 (2015),
  pages = 6,
  doi = 10.5171/2015.999601,
  abstract = {Objective: Primary Malignant Melanoma (PMM) arising from the digestive, respiratory or genitourinary tract is extremely rare. Rectal PMM accounts for less than 1% of all melanomas; it is often advanced at initial presentation with a poor prognosis with a 5-year survival below 20%. Treatment of this particular disease is still debated with weak evidence that aggressive surgery may lead to a better outcome. The objective of the present paper is to descibe a case of PMM and review the published literature on the treatment of such extremely rare condition. Methods: A 78 years old man presenting mild anal bleeding underwent a colonoscopy which showed a centimetric mass in the posterior wall of the rectum, less than 1 cm above the pectinea line. Biopsy revealed amelanotic malignant melanoma infiltrating the submucosa. Pre-operative assessment revealed no distant metastases and no nodal involvement. Abdomino-perineal resection (APR) with total mesorectal excision and iliac nodes sampling was performed. Results: the patient is alive and disease-free after 48 months from diagnosis. According to a literature review, APR with or without intra abdominal pelvic lymph node dissection represents a more radical approach in patients seeking curative options. However, some series suggest that wide local excision (WLE) may have similar survival outcomes but seems to be burdened with a higher rate of local recurrences. Conclusions: Our experience confirms that treatment recommendations are not standardized and tend to be individualized. An aggressive surgical approach may be justified in patient with a long life expectancy accepting a demolitive surgery and a definitive colonostomy.},
  keywords = {Rectal melanoma; primary; abdomino-perineal resection; wide local excision; survival.},
  note = Article ID: 999601
}