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

Objective: 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. Methods: 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. Results: 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. Conclusion: 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.