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. 2015:6C:26-8.
doi: 10.1016/j.ijscr.2014.11.060. Epub 2014 Nov 21.

Small bowel intussusception secondary to metastatic melanoma 15 years after complete excision of the primary tumor

Vincenzo Vigorita  1 , Fabio Ausania  2 , Marco Bertucci Zoccali  3 , Cristina Facal Alvarez  2 , Blanca De Urrutia Nadal  2 , Jose Enrique Casal Nuñez  2
Affiliations

Small bowel intussusception secondary to metastatic melanoma 15 years after complete excision of the primary tumor

Vincenzo Vigorita et al. Int J Surg Case Rep. 2015.

Abstract

Introduction: Primary intestinal melanoma is a rare entity, however the gastrointestinal tract, and particularly the small bowel, is a common site of recurrence from cutaneous melanoma. PRESENTATION OF CASE We report the case of a 48 year old woman with small bowel intussusception secondary to metastatic cutaneous melanoma, 15 years after excision of the primary tumor. The patient underwent an emergency small bowel resection with negative margins on final pathology.

Discussion: Surgical resection is a palliative, yet necessary, procedure in the setting of small bowel obstruction due to intussusception secondary to intestinal metastatic melanoma. In case of bowel metastasis, presenting symptoms are nonspecific and do not provide significant clues to the differential diagnosis of the underlying disease. In some patients, complete surgical resection of early diagnosed bowel metastases is associated with prolonged survival. Systemic chemotherapy in these patients does not provide survival benefit.

Conclusion: The occurrence of bowel relapse after very long disease free interval, while highly unlikely in most tumors, should always be considered in the differential diagnosis of patients with previous history of cutaneous malignant melanoma presenting with gastrointestinal symptoms.

Keywords: Intussusception; Melanoma metastasis.

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Figures

Fig. 1
Fig. 1
CT scan showing small bowel intussusception with evidence of change in diameter of the bowel.
Fig. 2
Fig. 2
Surgical specimen showing the invaginated bowel segment.
Fig. 3
Fig. 3
Open surgical specimen revealing a 5 cm × 5 cm neoplasia with superficial fibrinous exudate.
Fig. 4
Fig. 4
Immunohistochemistry for S100 showing intense and diffuse nuclear and cytoplasmic expression, consistent with melanoma (40×).
See this image and copyright information in PMC

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