Anal melanoma: An aggressive malignancy masquerading as hemorrhoids

Anal melanoma is a devastating malignancy easily confused with benign. hemo rrhoids. Physician unfamiliarity with Us bleeding rectal lesion can lead to delays in diagnosis and therapy. Four cases of anal melanoma, all initiall y mistaken for hemorrhoids, have been documented in the past 4 years at our institution. Despite surgical intervention and chemoimmunotherapy, each pa tient succumbed to widely metastatic disease. Average survival was 15.2 mon ths. The clinical, pathologic, surgical, and oncologic features of anal mel anoma are reviewed to enhance physician recognition of this unusual anorect al disorder.