This may cause discomfort as the full anal sac pushes on the anus. There are no randomized, comparative trials, rather, only retrospective reviews and institutional case series, most of which are relatively small in number and contain limited follow-up. All patients had either distant metastatic disease or bulky primary tumors with lymph node involvement. Int J Colorectal Dis. Pessaux and colleagues 11 at the Institut Gustave Roussy in France reviewed their records of 40 patients treated from to After this publication, however, during the s, the value of radical excision of anal melanoma was questioned, as relatively few patients survived in the long term and the majority of patients died of metastatic disease. Anal glands drain into anal crypts via anal ducts.
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