A Case of Anorectal Malignant Melanoma.

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The case is sixty-seven years old, female. Thirty-one months ago, a soybean-size black tumor was palpated at the anal orifice, but the tumor was ligated by her home doctor. She visited us because of the recurrence of the tumor. The tumor existed at the posterior wall of the anus and the size was of a walnut. The ultrasonographic examination disclosed that the inside echo of the tumor was not uniform and the tumor had obscure border and the size of the tumor was 5.0 X 4.2 X 3.8 cm. Similar findings were obtained by a CT-scan. Since it was diagnosed as malignant melanoma after performing needle biopsy, we first suggested that abdominal perineal resection followed by extensive resection of the lymph node should be performed. As the patient refused the procedure and no metastasis was found after performing transabdominal needle aspiration of retroperitoneal lymph node and also percutaneous aspiration of the inguinal lymph, local resection of the rectum via the anal sphincter was performed. Postoperatively, DAV therapy was performed and interferon was also administered as immunochemical treatments. At present, five months after the operation, no findings suggesting the recurrence were observed and noticed.
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