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26 July 2013 : Case report  India

Primary amelanotic melanoma of the rectum mimicking adenocarcinoma

Unusual clinical course, Challenging differential diagnosis

Manash Ranjan SahooABCDEF, Manoj Srinivas GowdaABCDEF, Raghavendra Mohan KaladagiBEFG

DOI: 10.12659/AJCR.889089

Am J Case Rep 2013; 14:280-283

Abstract

Background: Malignant melanoma is usually readily diagnosed by the presence of melanin granules. Although amelanotic melanoma contains a few melanin granules, it is often difficult to differentiate from non-epithelial malignant tumors. Immunohistochemical staining may be needed to diagnose the condition.
Case Report: This report describes a case of amelanotic melanoma of the rectum, which was originally suspected to be an adenocarcinoma, but was subsequently correctly diagnosed by immunohistochemical staining with HMB-45 antibody and by the presence of S-100 protein. A pinkish-red ulceroproliferative growth was located about 7 cm from the anal verge. The patient was treated by laparoscopic low anterior resection.
Conclusions: Very few cases of amelanotic melanoma of rectum have been reported in the literature and there is only limited clinical experience with this disease. It appears to be a highly lethal tumor and may need much more aggressive treatment than that used for carcinoma of the rectum.

Keywords: low anterior resection, Amelanotic melanoma

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923