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Amelanotic anorectal malignant melanoma in an ulcerative colitis patient: a rare coincidence or a rare association
  1. Anish John Kuriakose Kuzhiyanjal,
  2. Gaurav Bhaskar Nigam and
  3. Muhammad Afzal
  1. Gastroenterology, The Royal Oldham Hospital, The Pennine Acute Hospitals NHS Trust, Manchester, UK
  1. Correspondence to Dr Anish John Kuriakose Kuzhiyanjal; anishjon{at}gmail.com

Abstract

Inflammatory bowel disease (IBD) is a chronic inflammatory disorder of the gastrointestinal system, known to be associated with increased risk of carcinogenesis. We report the case of a 55-year-old woman, presenting with symptoms of increased bowel frequency, per rectal bleeding and rectal pain with a background of ulcerative colitis (UC). This was presumptively managed as UC flare, with titration of her medications to control the symptoms. However, a flexible sigmoidoscopy revealed an ulceroproliferative lesion in the rectum, which was identified as an amelanotic anorectal malignant melanoma on immunohistochemistry. No local or distant metastases were noted on radiological imaging. The tumour enlarged progressively and was managed with laparotomy and defunctioning stoma followed by palliative chemotherapy and immunotherapy. This is the first such case reported in literature, highlighting the importance of endoscopic assessment and the need to consider other differential diagnosis in patients with symptoms of IBD flare.

  • inflammatory bowel disease
  • ulcerative colitis
  • colon cancer
  • gastrointestinal surgery
  • endoscopy

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Footnotes

  • Contributors MA: Consultant gastroenterologist, under whom the patient was admitted; provided final approval of work. GBN: Registrar; edited and updated the literature. AJKK: Registrar; provided the initial draft and outline for the case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer-reviewed.