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Official websites use. Share sensitive information only on official, secure websites. Correspondence to: Giulia Malaguarnera, giulia. This is an open-access article distributed under the terms of the Creative Commons Attribution License 3. Anorectal melanoma is an uncommon and aggressive mucosal melanocytic malignancy. Due to its rarity, the pre-operative diagnosis remains difficult. The first symptoms are non-specific such as anal bleeding, anal mass or pain.
Although anorectal melanoma carries a poor prognosis; optimal therapeutics strategies are unclear. Surgical resection remains the mainstay of treatment. The optimal surgical procedure for primary tumours is controversial and can vary from wide local excision or endoscopic mucosal resection EMR to an abdomino-perineal resection. A high degree of uncertainly exists regarding the benefit of radiation therapy or chemotherapy.
The treatment of advanced melanoma is evolving rapidly with better understanding of the disease biology and immunology. Considerable effort has been devoted to the identification of molecular determinants of response to target therapies and immunotherapy. Keywords: malignant melanoma, mucosal melanoma, anorectal tumours, anorectal melanoma, treatment.
ARMM is often misdiagnosed in about two thirds of patients and most often as haemorrhoids, adenocarcinoma polyps and rectal cancer [ 3 ]. The typical symptoms such as anal pruritus or rectal pain can mimic haemorrhoids or rectal polyps [ 4 ]. ARMM can be confused with lymphoma, anorectal carcinomas or sarcoma because of its rarity and histological variability [ 5 ]. Comparing ARMM with other anorectal carcinomas, tumour cells can exhibit multiple cell types characteristics [ 6 , 7 ]. The poor knowledge about aetiology, pathogenesis and genetics of ARMM makes difficult proper diagnosis, treatment and prognosis.
ARMM accounts for only 1. The incidence of ARMM increases with age and the prevalence is 1. Lesions can affect anal canal, rectum or both, but the great majority of tumours are located with in 6 cm of the anal rim [ 11 ].