Abstract
Anal melanoma is a rare and highly aggressive malignancy that carries a poor prognosis. Due to its variable and ambiguous presentation, it is often misdiagnosed as a hemorrhoid, polyp, or an ulcer with a concomitant rectal prolapse. Clinicians usually have a low suspicion of anal melanoma due to its rarity and most people present with metastatic disease at the time of diagnosis. We report a case of a patient incidentally found to have anal melanoma. Prompt surgical resection with wide local excision versus abdominoperineal resection remains the mainstay of treatment as the added benefit of adjuvant chemoradiation or immunotherapy has been controversial.