Abstract
We have experienced a case of anorectal malignant melanoma in an very elderly woman who follows a favorable postoperative course after local resection without complains. The case involved a 90-year-old woman who presented to our hospital because of a 2-month history of anal bleeding at defecation. On digital examination, a painless elastic-hard tumor 20 mm in diameter was palpated at the anoretal region. Colonoscopy performed for further close examination disclosed a pedunculated tumor having the base at the dentate line. A biopsy resulted in anorectal malignant melanoma. Abdominal and pelvic CT scans showed bilateral inguinal swellings. We considered that radical operation including abdominoperineal resection and lymph node dissection might be difficult because her performance status (PS) was 3 due to the great age. However, her hemorrhagic symptom at defecation was so serious that we decided to perform local resection alone that complied with her and her family's wishes. The patient's postoperative course was uneventful, and she has been free from local recurrence and distant metastasis as of 27 months after the operation. The bilateral inguinal lymph node swellings have been unchanged in size.
