ABSTRACT
INTRODUCTION AND IMPORTANCE: Anorectal melanoma is a rare and aggressive malignancy that can be difficult to diagnose due to its nonspecific presentation. CASE PRESENTATION: We present a case of a 69-year-old woman who presented with painful defecation, bleeding per rectum, and a mass coming out of her anal opening. The initial differential diagnosis included hemorrhoids, rectal polyp, or a malignant lesion of the rectum. However, histopathological evaluation following transanal excision of the rectal mass revealed mucosal melanoma in the anorectal region. Further investigation showed no evidence of locoregional or distant metastasis. CLINICAL DISCUSSION: Surgery remains the primary treatment option for anorectal melanoma, but complete resection is often not feasible, leading to high rates of local recurrence and distant metastasis. The incidence of metastatic disease at the time of presentation is high, and a multidisciplinary approach is necessary to manage these patients. Currently, standard systemic therapies used for cutaneous melanoma are the mainstay of treatment for metastatic anorectal melanoma, but there is a need for further research to develop tailored treatment strategies. CONCLUSION: Our case report highlights the importance of considering anorectal melanoma in the differential diagnosis of patients presenting with anorectal symptoms. It emphasizes the need for a multidisciplinary approach to managing this rare malignancy. Early diagnosis, a multidisciplinary approach, and ongoing research into more effective treatments are crucial for improving outcomes for patients with anorectal melanoma.
ABSTRACT
PURPOSE: The aim of the paper is to assess the role and effectiveness of a proposed novel strategy for Life Cycle Inventory (LCI) data collection in the food sector and associated supply chains. The study represents one of the first of its type and provides answers to some of the key questions regarding the data collection process developed, managed and implemented by a multinational food company across the supply chain. METHODS: An integrated LCI data collection process for confectionery products was developed and implemented by Nestlé, a multinational food company. Some of the key features includes (1) management and implementation by a multinational food company; (2) types of roles to manage, provide and facilitate data exchange; (3) procedures to identify key products, suppliers and customers; (4) LCI questionnaire and cover letter and (5) data quality management based on the pedigree matrix. Overall, the combined features in an integrated framework provide a new way of thinking about the collection of LCI data from the perspective of a multinational food company. RESULTS AND DISCUSSION: The integrated LCI collection framework spanned across 5 months and resulted in 87 new LCI datasets for confectionery products from raw material, primary resource use, emission and waste release data collected from suppliers across 19 countries. The data collected was found to be of medium to high quality compared with secondary data. However, for retailers and waste service companies, only partially completed questionnaires were returned. Some of the key challenges encountered during the collection and creation of data included lack of experience, identifying key actors, communication and technical language, commercial compromise, confidentiality protection and complexity of multi-tiered supplier systems. A range of recommendations are proposed to reconcile these challenges which include standardisation of environmental data from suppliers, concise and targeted LCI questionnaires and visualising complexity through drawings. CONCLUSIONS: The integrated LCI data collection process and strategy has demonstrated the potential role of a multinational company to quickly engage and act as a strong enabler to unlock latent data for various aspects of the confectionery supply chain. Overall, it is recommended that the research findings serve as the foundations to transition towards a standardised procedure which can practically guide other multinational companies to considerably increase the availability of LCI data.
