Primary Melanoma of the Colon Presenting as Ileocecal Intussusception

Takahashi-Monroy, Takeshi; Vergara-Fernández, Omar; Avilés, Alejandro; Morales, Jose Martin; Gatica, Enrique; Suárez, E. Gómez

doi:10.1111/j.1572-0241.2006.473_6.x

Cited by 12 publications

(10 citation statements)

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“…The probable genesis of such tumors involves a concept of "ectodermal differentiation" - that ectodermal cells are capable of differentiation into multiple cell lines and may variably migrate into the colon during the embryologic stages to develop into melanocytes [7]. The omphalomesenteric duct may provide one potential route for this transfer of cells [3].…”

Section: Methodsmentioning

confidence: 99%

Pathogenesis, diagnosis and management of primary melanoma of the colon

et al. 2011

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BackgroundMelanomas within the alimentary tract are usually metastatic in origin. On the other hand, primary melanomas of the gastrointestinal tract are relatively uncommon. There are several published reports of melanomas occurring in the esophagus, stomach, small bowel, and anorectum. The occurrence of primary melanoma of the colon has, however, only been rarely reported. The optimum modus operandi for the management of primary colonic melanoma remains nebulous due to the limited number of reports in literature.MethodsA comprehensive search of Medline, Cochrane and Highwire was performed using the following keywords: 'melanoma', 'malignant melanoma', 'primary melanoma', 'colon', 'gastrointestinal tract', 'alimentary tract', 'digestive tract', and 'large bowel'. All patients with primary melanoma localized to the colon were included in the review. Patients with metastatic melanomas to the gastrointestinal (GI) tract and primary melanomas localized to the GI tract in anatomic locations other than colon were excluded.ResultsThere have been only 12 reported cases of primary melanoma of the colon to date. The average age of patients on presentation was 60.4 years without any significant gender predilection. Right colon (33%) and cecum (33%) were the most common sites for the occurrence of primary colonic melanoma while abdominal pain (58%) and weight loss (50%) were the most common presenting complaints. Colonoscopy is the most reliable diagnostic investigation and offers the additional advantage of obtaining tissue for diagnosis. S-100 and HMB-45 are highly sensitive and specific for the diagnosis of this malignancy. For primary colonic melanomas that have not metastasized to any distant parts of the body, surgical resection with wide margins appears to be the treatment of choice. Although the management was individualized in every case, most of the authors preferred traditional hemicolectomy as the favored surgical approach. Chemotherapeutic agents including interferons, cytokines, biological agents and radiation therapy for brain metastases have been reported as adjuvant and palliative options while considering malignant melanomas in general. The average recurrence-free interval was 2.59 years. Nine of the 12 reports documented follow-up in their patients. Two of these 9 (22.2%) patients died.ConclusionsPrimary melanoma of the colon is a rare clinical entity. Whenever a seemingly primary melanoma is detected in an atypical location such as the colon, it is prudent to conduct a thorough clinical investigation to consider the possibility of metastatic disease. Further studies are needed to document the long term follow-up, survival advantage and safety of the management approaches employed in patients with primary colonic melanoma. Based on current data, surgical resection appears to be appropriate management for primary colonic melanomas; unless the disease has metastasized to distant sites where surgery may have a limited palliative role.

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Section: Methodsmentioning

confidence: 99%

Pathogenesis, diagnosis and management of primary melanoma of the colon

et al. 2011

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“…Although a limited number of studies, intestinal obstruction secondary to intussusception is the most frequent clinical presentation of primary melanoma. 1,9,10,11,12 The presentation of our patient was ileocecal intussusception due to metastatic melanoma of the intestines.…”

Section: Discussionmentioning

confidence: 94%

Ileocecal Intussusception Secondary to Bowel Metastases from Cutaneous Melanoma: Case Report

Yücel¹,

Filiz²,

Kurt³

et al. 2017

TJCD

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Altmış üç yaşındaki erkek hasta karın ağrısı, kanlı dışkılama, bulantı ve kusma şikayetleri ile hastaneye müracaat etti. Yapılan muayene ve tetkiklerinde; bilgisayarlı tomografide intestinal intussusepsiyon ve karın içi lenf düğümleri saptandı. Kolonoskopik inceleme sonrası redüksiyon sağlanamadı. Laparotomide, çekuma invajine ince barsak segmentleri redükte olmaması üzerine sağ hemikolektomi ve palpasyonda ince barsakta lümen içi saptanan tümöral kitleleri içine alan 60 cm ince barsak segmenti rezeke edildi. Patolojik inceleme sonrasında kolonda 1 ve ince barsaklarda 8 toplamda 9 adet polipoid lezyon saptandı. Histolojik incelemede sitoplazmik melanin birikimi ile epiteloid ve iğsi tümör hücreleri izlendi. İmmünohistokimyasal boyamada tümör hücrelerinde S-100, HMB-45 ve melan-A pozitif olarak bulundu. Moleküler incelenmesi BRAF geni 15 Ekzonlar c.1799> a (p.v600 A) mutasyon saptanan hastanın malign melonom olarak rapor edilmesi sonrası hasta yeniden değerlendirildi ve göğüs ön duvarında deride malign melanom saptandı. Anahtar Kelimeler: İntussusepsiyon, metastaz, melanom ÖZ ABSTRACTA 63-year-old man presented to the emergency department with abdominal pain, episodes of bloody stool, nausea, and vomiting. Abdominal computed tomography showed lower intestinal intussusception and enlarged lymph nodes. Colonoscopic reduction was not possible. Exploratory laparotomy revealed a 15-cm mass comprised of the ileocecal region that had intussuscepted secondary to the small bowel. Palliative right hemicolectomy and resection of 60 cm segments of the small bowel were performed. Pathologic examination of the excised specimen revealed polypoid masses. There were 9 polyps, 1 in the ascending colon and the others in the ileum. Histopathological examination demonstrated obvious features of melanoma associated with epitheloid and spindle tumor cells and cytoplasmic melanin deposition. The tumor cells showed positivity for S-100, HMB-45 and Melan-A. Molecular examination revealed a c.1799> A (p.v600 A) mutation in exon 15 of the BRAF gene. The patient was re-examined and a nevus was found on the left anterior chest wall.

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“…Additionally, this idea precludes disease originating in the colon [ 4 , 5 ]. A second, and more inclusive, hypothesis argues a defect in ectodermal differentiation and migration causing the melanocytes to reside inappropriately in the GI tract [ 6 – 8 ]. Despite these theories, the cause of primary GI melanomas remains a mystery.…”

Section: Discussionmentioning

confidence: 99%

Primary versus Metastatic Gastrointestinal Melanoma: A Rare Case and Review of Current Literature

Simons

Ferreira

Meunier

et al. 2016

Case Reports in Gastrointestinal Medicine

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Gastrointestinal (GI) melanomas are a rare diagnostic entity. Although there have been cases of melanomas solely in the GI tract, many debate their true origin: the gut versus a distant, undetected primary lesion that regressed known as melanoma of unknown primary. We present a case that involved diagnosing a GI melanoma and then backtracking to find a possible primary source. We review the most recent literature regarding possible etiologies of primary GI melanomas and how to differentiate whether it has a primary, metastatic, or unknown origin.

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Primary Melanoma of the Colon Presenting as Ileocecal Intussusception

Cited by 12 publications

References 0 publications

Pathogenesis, diagnosis and management of primary melanoma of the colon

Pathogenesis, diagnosis and management of primary melanoma of the colon

Ileocecal Intussusception Secondary to Bowel Metastases from Cutaneous Melanoma: Case Report

Primary versus Metastatic Gastrointestinal Melanoma: A Rare Case and Review of Current Literature

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