Malignant melanoma of the anus

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Abstract
A report of 12 patients with anal melanoma (AM) is presented, and 255 cases reported since 1947 are reviewed. Combining these patients with those from the literature, several aspects of AM that are controversial or have not been studied in a systematic manner are analyzed. The mean clinical tumor size was 4.1 cm. Seventy percent were grossly pigmented, 63% were polypoid and 44% were prolapsed. Two-thirds of AM were located in the proximal pecten, at or near the level of the anal valves. Microscopically, the most useful diagnostic criteria were melanin production, junctional change and a nesting growth pattern. In 4 of the presented cases, atypical junctional change extended laterally from the overt invasive neoplasm for distances up to 1 cm. Of the patients, .apprx. 60% had metastases at the time of diagnosis. There was no statistical difference in determinate survivals of patients treated for cure by local excision and abdominoperineal resection. Neither tumor size nor configuration affected survival. The choice of therapy was not influenced by tumor size.

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