Evidence map›Paper›PMID 40875164›Full record

ArticleUpdates in surgery2025

Consider the unexpected! An overlooked, elusive, rare but dramatic diagnosis: anorectal melanoma.

Rossella Melcarne, Chiara Eberspacher, Massimiliano Mistrangelo, Pietro Quaglino, Rebecca Senetta, Arcangelo Picciariello, Leonardo Vincenti, Daniela Rega, Paolo Delrio, Corrado Caracò and 10 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Updates in surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Rossella Melcarne *Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico, 155, 00161, Rome, Italy. rossella.melcarne@uniroma1.it.ORCID http://orcid.org/0000-0002-2820-7607
Chiara Eberspacher *Department of General Surgery, Sapienza University of Rome, Viale del Policlinico, 155, 00161, Rome, Italy.
Massimiliano MistrangeloSurgical Science Department, Centre of Minimal Invasive Surgery, Città Della Salute E Della Scienza Hospital, University of Turin, Turin, Italy.
Pietro QuaglinoDepartment of Medical Sciences, Sections of Dermatology, University of Turin, Turin, Italy.
Rebecca SenettaPathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy.
Arcangelo PicciarielloDepartment of Experimental Medicine, University of Salento, Lecce, Italy.
Leonardo VincentiSurgical Unit, IRCCS de Bellis, Castellana Grotte, 70013, Bari, Italy.
Daniela RegaColorectal Surgical Oncology, Department of Abdominal Oncology, Istituto Nazionale Tumori-IRCCS "Fondazione G. Pascale", Naples, Italy.
Paolo DelrioColorectal Surgical Oncology, Department of Abdominal Oncology, Istituto Nazionale Tumori-IRCCS "Fondazione G. Pascale", Naples, Italy.
Corrado CaracòDivision of Surgery of Melanoma and Skin Cancer, Istituto Nazionale Tumori 'Fondazione Pascale' IRCCS, Naples, Italy.
Mariarosaria PortinaioDepartment of Clinical Medicine and Surgery, University of Naples Federico II, Via S. Pansini, 5, 80131, Naples, Italy.
Stefano ArcieriDepartment of General Surgery, Sapienza University of Rome, Viale del Policlinico, 155, 00161, Rome, Italy.
Giovanni PaolinoUnit of Dermatology, IRCCS Ospedale San Raffaele, Milan, Italy.
Santo Raffaele MercuriUnit of Dermatology, IRCCS Ospedale San Raffaele, Milan, Italy.
Carmen CantisaniDepartment of Dermatology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
Chiara ScorzielloSant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
Tal Deborah EngelDepartment of General and Specialized Surgery and Anesthesiology , Sapienza University of Rome, Viale del Policlinico, 155, 00161, Rome, Italy.
Laura GiacomelliDepartment of General and Specialized Surgery and Anesthesiology , Sapienza University of Rome, Viale del Policlinico, 155, 00161, Rome, Italy.
Marco BiffoniDepartment of General and Specialized Surgery and Anesthesiology , Sapienza University of Rome, Viale del Policlinico, 155, 00161, Rome, Italy.
Domenico MascagniDepartment of General Surgery, Sapienza University of Rome, Viale del Policlinico, 155, 00161, Rome, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAnorectal melanoma (AM) is a rare and aggressive malignancy, often misdiagnosed due to its clinical resemblance to benign anorectal conditions. Early diagnosis remains challenging, with a poor prognosis and high rates of metastasis at presentation.

methodsWe conducted a retrospective multicenter study of 21 patients diagnosed with AM between 2013 and 2023 across four high-volume Italian surgical centers. Patients were stratified into two groups based on whether AM was suspected at initial evaluation (Group A) or incidentally diagnosed after surgery for presumed benign disease (Group B). Clinical, diagnostic, treatment, and outcome data were analyzed.

resultsOnly 24% of patients had AM suspected at first presentation. These patients were younger (median age 49 vs. 70 years) and had larger, more readily identifiable tumors. However, nodal and distant metastases were equally frequent in both groups (lymph node metastases: 52.4%; distant metastases: 19%). Most patients underwent wide local excision (71.4%), while only one required abdominoperineal resection. Postoperative recurrence occurred in 47.6% of cases. Median survival was 11 months in Group A and 24 months in Group B. In 90.5% of cases, previous specialist consultations had failed to achieve timely diagnosis, highlighting missed diagnostic opportunities.

conclusionsAM is frequently overlooked due to its rarity and non-specific presentation. Earlier recognition alone may not improve outcomes, but systematic histopathological assessment, targeted biopsy, and multidisciplinary management remain essential. Conservative surgery with early use of systemic therapy should be prioritized when feasible.

Indexed as

Anus NeoplasmsMelanomaRectal NeoplasmsAdultAgedAged, 80 and overFemaleHumansItalyLymphatic MetastasisMaleMiddle AgedRetrospective StudiesAnal cancerAnal melanomaMucosal melanomaMultidisciplinary managementRare malignancyWide local excision

Identifiers

PMID40875164
PMCPMC12630238

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.