THE SURGICAL MANAGEMENT OF ANORECTAL MALIGNANT MELANOMA

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Abstract
The biological vagaries of anal malignant melanoma are illustrated by 4 cases in Chinese patients. All 4 died within 5 yr. Their poor prognosis emphasizes the value of preoperative studies to detect clinically occult metastases and obviate futile radical surgery. Many patients already have disseminated disease at the time of diagnosis. Local excision of the tumor provides acceptable palliation. For localized disease, abdominoperineal resection prevents local recurrence and removes the mesenteric nodes which are frequently involved. Palpable inguinal nodes necessitate therapeutic groin dissection, elective resection is performed only when affected nodes are found at laparotomy. Pelvic lymphadenectomy should be performed in conjunction with abdominoperineal resection. The efficacy of chemotherapy for anorectal melanoma remains uncertain.

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