Intestinal metastasis of malignant melanoma of unknown primary localization
##plugins.themes.bootstrap3.article.main##
##plugins.themes.bootstrap3.article.sidebar##
Abstract
Malignant melanoma (MM) has been shown to metastasize with relative affinity to the gastro-intestinal (GI) tract, especially through the small intestine, mostly within, but also later than the first 5 years after initial diagnosis. MM appears to less often originate in the GI tract. Surgical excision is reported to be safe and capable of improving oncological outcomes in the absence of other metastatic disease. We hereby report the case of a patient without a history of MM presenting in our clinic with severe anemia due to a tumor located in the small bowel diagnosed on abdominal tomography. Surgery consisted in a radical resection of the affected small bowel segment. Pathological examination revealed a MM metastasis to the jejunum. On further investigation of the patient, a cutaneous lesion suggestive of MM was identified on his right upper limb, which was excised, and the patient has been referred to the multidisciplinary team for initiation of adjuvant chemotherapy. Further follow-up is required due to MMs propensity for multiple metastases. This case emphasizes the fact that in a patient diagnosed with an intestinal tumor a thorough clinical examination should be performed, as one of the possible differential diagnosis of intestinal tumors is the metastatic localization of a cutaneous MM.
##plugins.themes.bootstrap3.article.details##
malignant melanoma, intestinal metastasis, enterectomy, gastro-intestinal bleeding, anemia
2. Amersi F, Terando A, Goto Y, et al. Activation of CCR9/CCL25 in cutaneous melanoma mediates preferential metastasis to the small intestine. Clin Cancer Res 2008; 14(3):638-645.
3. Conversano A, Macina S, Indellicato R, Lacavalla D, DAbbicco D. Gastrointestinal bleeding as presentation of small bowel metastases of malignant melanoma: Is surgery a good choice? Int J Surg Case Rep 2014; 5(10):774-778.
4. Patel K, Ward S, Packer T, et al. Malignant melanoma of the gastro-intestinal tract: A case series. Int J Surg 2014; 12(5):523-527.
5. Gupta T, Brasfield R. Metastatic melanoma. A clinicopathological study. Cancer 1964; 17(10):1323-1339.
6. Sanki A, Scolyer R, Thompson J. Surgery for melanoma metastases of the gastrointestinal tract: Indications and results. E J Surg Oncol (EJSO) 2009; 35(3):313-319.
7. Dummer R, Hauschild A, Lindenblatt N, Pentheroudakis G, Keilholz U. Cutaneous melanoma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2015; 26(suppl 5):v126-v132.
8. Weber J, Kähler K, Hauschild A. Management of immune-related adverse events and kinetics of response with ipilimumab. J Clin Oncol 2012; 30(21):2691-2697.
Archive of Clinical Cases is protected by copyright and may be used in accordance with copyright and other applicable laws. Content available at www.clinicalcases.eu and our digital applications is intended for personal noncommercial use.
Authors who submit a manuscript for publication in Archive of Clinical Cases agree to the following terms: a. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal. b. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal. c. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) only after the final version of the manuscript was accepted and published, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access). d. It is compulsory that before submission authors ensure that their work was not published in any other medical journals or pending acceptance for publication and that "Archives of Clinical Cases" is the only beneficiary at that moment if their work/case will be accepted by us.
Guidelines for linking to www.clinicalcases.eu a. The main purpose of the site linking to the Archive of Clinical Casess site should be educational. b. Links should be made to the Archive of Clinical Casess home page (www.clinicalcases.eu) or to the articles abstract. c. It is forbidden to use the Archive of Clinical Casess cover by outside organizations unless permission has been granted in advance, notifying our Secretary. d. Material owned by the Archive of Clinical Cases (including the name, logo, cover, and text) may not be used in any manner that may induce the idea or suggest that the Archive of Clinical Cases is in some way recommending a specific company, product or service. e. You must not use or allow others to access or use, all or any part of our Site or the contents and/or applications on it for commercial purposes without our permission. To seek permission to do anything prohibited by or not contained in these TERMS, or which requires our prior consent or agreement, you can contact us.