Successful multimodality treatment of anorectal melanoma after wide local excision: a case report

TL;DR

A 61-year-old man with anorectal melanoma showed good long-term outcomes after treatment combining surgery, bevacizumab, and immunotherapy.

Contribution

This case demonstrates the feasibility of combining local excision with targeted and immunotherapy for anorectal melanoma.

Findings

The patient remained in good condition with no systemic metastasis after nearly three years of follow-up.

Combination therapy included bevacizumab, anti-PD-1 immunotherapy, and local excision.

Enlarged lymph nodes were observed but did not cause symptoms or signs of metastasis.

Abstract

The purpose of this case report is to explore the efficacy of comprehensive treatment of anal melanoma and to provide reference for the treatment of anal melanoma.

A rare case of anorectal melanoma was collected. After local excision, the patient was treated with a combination of the anti-vascular survival drug bevacizumab, anti-PD-1 immunotherapy and other treatments, and the patient’s prognosis and survival were observed.

A 61-year-old male was admitted to the hospital with complaints of anal prolapse and a mass appearing after defecation, accompanied by intermittent bloody stool for one week. He was initially diagnosed with mixed hemorrhoids, and a hemorrhoidectomy was performed. Postoperative pathology confirmed malignant melanoma with negative surgical margins, leading to a clinical diagnosis of AM. Following local excision surgery, the patient underwent targeted therapy with bevacizumab, anti-PD-1 immunotherapy and other treatments. After nearly three years of follow-up, the patient remained in good condition and while follow-up CT and MRI revealed some enlarged lymph nodes, there were no symptoms or signs of systemic metastasis.

The combination of local resection of the primary lesion with bevacizumab targeted therapy and anti-PD-1 immunotherapy is feasible and can substantially improve the survival time of patients with AM.

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