- Anal melanoma is a rare and aggressive form of melanoma, accounting for 0.5-2% of anal malignancies. It commonly presents with bleeding per rectum in patients around age 70. - Diagnosis involves visual inspection, biopsy, and immunohistochemistry confirming S100 and HMB45 markers. Surgery with wide local excision is the primary treatment for stage I-II disease. - Prognosis is poor with average survival of 11-20 months for early stage and less than 10 months for stage III metastatic disease. Targeted therapies for common mutations show promise but survival has only improved by 3-5 months.