• Xingdong Xu, Ting Ge, and Gang Wang.
• Department of General Surgery.
• Medicine (Baltimore). 2020 Jan 1; 99 (5): e19028e19028.

IntroductionAnorectal malignant melanoma (AMM) is a rare and aggressive malignance with poor prognosis, yet no consensus of treatment exists to date. Abdominoperineal resection surgery (APR) is the standard treatment of anorectal malignant melanoma, capable of controlling lymphatic spread and obtaining a large negative margin for local control but it can lead to complications. Wide local excision (WLE) allows for quicker recovery and has minimal impact on bowel function (i.e., bypassing the need for a stoma).Patient ConcernsA 66-year-old male patient presented with a 2-months history of painless rectal bleeding.DiagnosisThe characteristic finding from colonoscopy and magnetic resonance imaging led to a diagnosis of colorectal cancer. Immunohistochemistry analyses confirmed malignant melanoma. The tumor was classified as: HMB-45(+), S-100(+), CD117(±), PCK(-), ki-67(+, 10%).InterventionsThe patient underwent abdominoperineal resection with no other adjuvant therapy.OutcomesThe patient is doing well at 24 month after the operation, with no signs of recurrence.ConclusionAMM is a rare malignance, and is easy to misdiagnose. The therapy approach remains controversial. Every effort should be made to ensure prompt diagnosis and to define the optimally effective standard therapy approach.

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