대한대장항문학회

Primary melanoma of anorectum is a very rare, aggressive tumor with a reported 5-year<br>survival rate of 6%. Over 90% of all anorectal melanomas arise at the dentate line, but primary<br>lesions well above this line in the rectum or rectosigmoid have been reported. Surgical<br>treatments of this virulent tumor have ranged from conservative approach, such as wide local<br>excision to abdominoperineal resection (APR) with or without bilateral inguinal<br>lymphadenectomy. When wide local excision was compared to APR in terms of survival, no<br>significant difference was noted. However, five-year survivors had 2 mm thin lesion, and<br>underwent radical surgery. We have experienced three cases of primary anorectal melanoma,<br>two of which underwent radical surgery and survived 20 months and 6 months respectively.<br>One patient had wide local excision, and survived 5 months. One of the three patient had von<br>Recklinghausen disease with caf -au-lait spots and primary melanoma, which is probably one<br>of the first reported case in the literature.<br>