Metastatic Melanoma Causing Jejunal Intussusception

Mucci, Tania; Long, William D.; Witkiewicz, Agnes; Mastrangelo, Michael J.; Rosato, Ernest L.; Berger, Adam C.

doi:10.1007/s11605-007-0215-y

Cited by 25 publications

(23 citation statements)

References 10 publications

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“…To date, only six cases of perforation due to melanoma intestinal metastasis have been reported [11][12][13][14][15] and less than twenty cases of small bowel intussusception secondary to metastatic skin melanoma have been reported up to 2007. 16 Due the rarity of occurrence of small bowel melanoma, the unspecificity of clinical complaints and the difficulty to explore the intestinal loops with the common instrumental procedures, preoperative diagnosis of small intestine melanoma results often difficult to perform. Different imaging techniques [Echo, TC, PET, capsule endoscopy] may give a suspicion of intestinal neoplasm, however the final diagnosis can be obtained only after surgical exploration.…”

Section: Discussionmentioning

confidence: 99%

Intestinal melanoma: A broad spectrum of clinical presentation

Patti

Cacciatori

Guercio

et al. 2012

International Journal of Surgery Case Reports

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Section: Discussionmentioning

confidence: 99%

Intestinal melanoma: A broad spectrum of clinical presentation

Patti

Cacciatori

Guercio

et al. 2012

International Journal of Surgery Case Reports

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“…Superficial spreading melanoma is the most common type of melanoma (70-80%) and therefore responsible for most gastrointestinal metastases, which can develop even more than 10 years after resection of the primary cutaneous lesion. 4,7,8 Around 60% of the patients who suffer from melanoma have small bowel metastases at the moment of death, but in only 1-4% of the cases they are detected as complications occur. 4 These include abdominal pain, intestinal obstruction, weight loss or anemia due to chronic enterorrhagia.…”

Section: Discussionmentioning

confidence: 99%

“…4 These include abdominal pain, intestinal obstruction, weight loss or anemia due to chronic enterorrhagia. 7 Intestinal obstruction due to the intussusception of these lesions is a rare event. Less than 25 cases have been reported in the literature so far.…”

Section: Discussionmentioning

confidence: 99%

Ileocolic intussusception due to intestinal metastatic melanoma. Case report and review of the literature

Alvarez

Nicolás

Goransky

et al. 2011

International Journal of Surgery Case Reports

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The small intestine is a frequent site of melanoma metastases and the most common cause of secondary intestinal tumors. Even though, its presentation with intestinal obstruction due to intussusception is very rare. We present a 47-year-old woman with a medical history of facial melanoma operated 17 years ago and recently diagnosed of cervical recurrence who complained of abdominal pain of one week duration accompanied with vomiting and abdominal distension. Computed tomography (CT) scan revealed marked distension of the small intestine with features suggesting intussusception of the distal ileum. At laparoscopic exploration a massive ileocolic intussusception was found with invagination of the last 60 cm of ileum inside the cecum and ascending colon. Surgical reduction revealed a tumor of approximately 2 cm in the distal end of the intussuscepted intestine acting as the lead point. Resection of non-viable ileum along with the tumor and end-to-end anastomosis was performed. Many other lesions of smaller size were found distantly in the proximal small bowel but were not treated. The patient had a full recovery and was discharged three days after surgery. Pathological examination showed metastatic melanoma and a positron emission tomography (PET) scan confirmed disseminated disease with brain metastasis. The patient died three months after surgery. Intestinal occlusion due to metastatic disease is a rare condition but should be taken into account particularly in patients with history of cancer. Surgical intervention with a mini-invasive laparoscopic approach is feasible. Intestinal resection and anastomosis is mandatory for either curative or palliative intentions providing a satisfactory treatment.

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“…For a long time clinical signs are non-specific and it is not evident to establish a definitive diagnosis prior to the onset of complications (8,15). Abdominal pain and upper gastrointestinal bleeding (occult or overt) are present in 60% and 50% respectively, while changes in bowel habit, nausea, vomiting and weight loss are less common, but complete the clinical presentation (16)(17)(18). The typical mechanism of obstruction is invagination (19)(20)(21)(22)(23)(24).…”

Section: Discussionmentioning

confidence: 99%

Small Bowell Malignant Melanoma-Report of Three Cases and Review of Literature

Târcoveanu

Dimofie

Dănilă

et al. 2009

Acta Chirurgica Belgica

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Malignant melanomas have a predilection to metastasize to the small bowel. Three patients with malignant melanoma involving the small bowel are reported. Two patients were operated on for small bowel obstruction and the third for gastrointestinal bleeding with anemia. Two patients remained well 6 month and 2 years, respectively, after surgery. One patient died of metastatic cerebral melanoma 6 months postoperatively. One should suspect small bowel metastasis in every patient with malignant melanoma in his past medical history, who presents with recent changes in bowel habits, intestinal obstruction or gastrointestinal bleeding. Preoperative assessment can only raise the suspicion, even with advanced imaging methods: capsule endoscopy, enteroscopy, CT or PET-CT. The only therapeutic procedure is surgical resection, offering both short term survival as well as an improvement in the quality of life. Although prognosis is dismal there are factors associated with prolonged survival: complete surgical resection with no residual primary or metastatic tumor, so-called primary small bowel tumors in patients aged more then 60 years, LDH < 200 U/L, lack of tumor spread in mesenteric lymph nodes.

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Metastatic Melanoma Causing Jejunal Intussusception

Cited by 25 publications

References 10 publications

Intestinal melanoma: A broad spectrum of clinical presentation

Intestinal melanoma: A broad spectrum of clinical presentation

Ileocolic intussusception due to intestinal metastatic melanoma. Case report and review of the literature

Small Bowell Malignant Melanoma-Report of Three Cases and Review of Literature

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