Primary anorectal melanoma: A case report with extended follow-up

Primary anorectal melanoma on FDG PET/CT

Primary anorectal melanoma is an extremely rare, aggressive malignancy with a poor prognosis. A 76-year-old man with a 2-month history of rectal bleeding, anal pain, and tenesmus was referred for an F-FDG PET/CT examination, which revealed an abnormal focal FDG uptake on the lower rectum with multiple other intense FDG-avid regions in locoregional pelvic lymph nodes, bones, liver, and lung. It was highly suggestive of malignancy, and a provisional diagnosis of advanced rectal carcinoma was made. However, a following tissue biopsy of the lesion on the lower rectum performed by colonoscopy histopathologically indicated primary anorectal melanoma.

Primary Malignant Melanoma of the Esophagus: A Case Report and Review of the Literature

BACKGROUND Primary malignant melanoma of the esophagus (PMME) is a rare cancer with a poor prognosis. It is often difficult to differentiate from non-epithelial malignant tumors, and immunohistochemical staining may be needed to diagnose the condition. The mainstay of treatment is usually surgical with curative or palliative intent, since radio- and chemotherapy do not really improve the outcome. The average survival rate after surgery is 34.5 months. At the time of diagnosis, 40-80% of cases have local regional lymph node metastases. CASE REPORT The case of a 67-year-old male patient with PMME is reported. He presented with progressive dysphagia. A computerized tomography was performed in which a polypoid mass was observed in the distal esophagus. It was originally suspected to be an adenocarcinoma, but was subsequently correctly diagnosed by immunohistochemical staining with HMB-45 antibody and by the presence of S-100 protein. A subtotal esophagectomy was performed. CONCLUSIONS Very few cases of PMME have been reported in the literature and there is only limited clinical experience with this disease. Therefore, it is very difficult to establish clear criteria for clinical recognition of this type of melanoma. Early histopathological confirmation of the character is essential for further treatment in case of confirmation of malignancy.