Endoscopic Submucosal Dissection as a Diagnostic and Minimally Invasive Therapeutic Excision Modality for Primary Anorectal Malignant Melanoma

Primary anorectal malignant melanoma is a rare mucosal malignancy with nonspecific symptoms, frequent misdiagnoses, delayed treatment, and the lack of an established standard therapeutic strategy are the reasons for a poor prognosis. Diagnostic challenges are further compounded by the low rate of preoperative histological confirmation, especially for amelanotic lesions. Given its poor prognosis, performing a less invasive resection is crucial. We herein report the case of an 82-year-old male patient who underwent endoscopic submucosal dissection as a total biopsy and was treated with immune checkpoint inhibitors as adjuvant therapy.