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Metastatic Malignant Melanoma of the Small Bowel—Report of Two Cases

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Abstract

Case Report

We report two cases of malignant melanoma metastasizing to the ileum and jejunum in a 48-year-old female and 62-year-old male, respectively. The female patient was a known case of vaginal melanoma who on follow-up developed pain abdomen 4 years after excision of the primary, whereas the male patient who was initially referred as pleomorphic spindle cell sarcoma of the groin presented with complaints of bleeding per rectum and melena 6 years later.

Results

After preliminary investigations both underwent laparotomy and resection of segments of ileum and jejunum with tumor. Histopathological examination with immunohistochemistry showed features suggestive of metastatic malignant melanoma.

Discussion

Metastasis should be suspected in patients with malignant melanoma who develop gastrointestinal symptoms such as abdominal pain, anemia, melena, fatigue, constipation, small bowel obstruction, or perforation. This helps in avoiding a delay in the diagnosis and complications that arise due to metastatic disease.

Conclusion

Our first patient with primary vaginal melanoma died of multiple metastases 11 months following surgery for the ileal metastasis while the second patient with jejunal metastasis developed recurrent disease in the small bowel and iliac lymph nodes 10 months after surgery. However, in a patient with isolated gastrointestinal metastasis, diagnosed early, with good general condition surgical management should be encouraged when a complete resection of the disease is feasible as no other treatment option is as good for relief of symptoms and prolongation of life.

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References

  1. DiSario JA, Burt RW, Vargas H, McWhorter WP. Small bowel cancer:epidemiological and clinical characteristics from a population-based registry. Am J Gastroenterol. 1994;89:699–701.

    PubMed  CAS  Google Scholar 

  2. Dasgupta TK, Bradsfield RD. Metastatic melanoma of the gastrointestinal tract. Arch Surg. 1964;88:969–73.

    Article  PubMed  CAS  Google Scholar 

  3. Patel JK, Didolkar MS, Pickren JW, Moore RH. Metastatic pattern of malignant melanoma. A study of 216 autopsy cases. Am J Surg. 1978;135:807–10.

    Article  PubMed  CAS  Google Scholar 

  4. Oguri H, Izumiya C, Maeda N, Fukaya T, Moriki T. A primary amelanotic melanoma of the vagina, diagnosed by immunohistochemical staining with HMB-45, which recurred as a pigmented melanoma. J Clin Pathol. 2004;57:986–8.

    Article  PubMed  CAS  Google Scholar 

  5. Bender GN, Maglinte DD, McLarney JH, Rex D, Kelvin FM. Malignant melanoma: patterns of metastasis to the small bowel, reliability of imaging studies, and clinical relevance. Am J Gastroenterol. 2001;96:2392–400.

    PubMed  CAS  Google Scholar 

  6. Liang KV, Sanderson SO, Nowakowski GS, Arora AS. Metastatic malignant melanoma of the gastrointestinal tract. Mayo Clin Proc. 2006;81:511–6.

    Article  PubMed  Google Scholar 

  7. Richmond A. CCR9 homes metastatic melanoma cells to the small bowel. Clin Cancer Res. 2008;14:621–3.

    Article  PubMed  CAS  Google Scholar 

  8. Tarantino L, Nocera V, Perrotta M, Balsamo G, Schiano A, Orabona P, et al. Primary small-bowel melanoma: color Doppler ultrasonographic, computed tomographic, and radiologic findings with pathologic correlations. J Ultrasound Med. 2007;26:121–7.

    PubMed  Google Scholar 

  9. Schuchter LM, Green R, Fraker D. Primary and metastatic diseases in malignant melanoma of the gastrointestinal tract. Curr Opin Oncol. 2000;12:181–5.

    Article  PubMed  CAS  Google Scholar 

  10. Reinhardt MJ, Joe AY, Jaeger U, Huber A, Matthies A, Bucerius J, et al. Diagnostic performance of whole body dual modality 18F-FDG PET/CT imaging for N- and M-staging of malignant melanoma: experience with 250 consecutive patients. J Clin Oncol. 2006;1(24):1178–87.

    Article  Google Scholar 

  11. Elsayed AM, Albahra M, Nzeako UC, Sobin LH. Malignant melanomas in the small intestine: a study of 103 patients. Am J Gastroenterol. 1996;91:1001–6.

    PubMed  CAS  Google Scholar 

  12. Wood TF, DiFronzo LA, Rose DM, Haigh PI, Stern SL, Wanek L, et al. Does complete resection of melanoma metastatic to solid intra-abdominal organs improve survival? Ann Surg Oncol. 2001;8:658–62.

    Article  PubMed  CAS  Google Scholar 

  13. McLoughlin JM, Zager JS, Sondak VK, Berk LB. Treatment options for limited or symptomatic metastatic melanoma. Cancer Control. 2008;15:239–47.

    PubMed  Google Scholar 

  14. Lens M, Bataille V, Krivokapic Z. Melanoma of the small intestine. Lancet Oncol. 2009;10:516–21.

    Article  PubMed  Google Scholar 

  15. Ollila DW, Essner R, Wanek LA, Morton DL. Surgical resection for melanoma metastatic to the gastrointestinal tract. Arch Surg. 1996;131(975–9):979–80.

    Google Scholar 

  16. Ricaniadis N, Konstadoulakis MM, Walsh D, Karakousis CP. Gastrointestinal metastases from malignant melanoma. Surg Oncol. 1995;4:105–10.

    Article  PubMed  CAS  Google Scholar 

  17. Agrawal S, Yao TJ, Coit DG. Surgery for melanoma metastatic to the gastrointestinal tract. Ann Surg Oncol. 1999;6:336–44.

    Article  PubMed  CAS  Google Scholar 

  18. Branum GD, Seigler HF. Role of surgical intervention in the management of intestinal metastases from malignant melanoma. Am J Surg. 1991;162:428–31.

    Article  PubMed  CAS  Google Scholar 

  19. Sanki A, Scolyer RA, Thompson JF. Surgery for melanoma metastases of the gastrointestinal tract: indications and results. Eur J Surg Oncol. 2009;35:313–9.

    Article  PubMed  CAS  Google Scholar 

  20. Batsakis JG, Suarez P. Mucosal melanomas: a review. Adv Anat Pathol. 2000;7:167–80.

    Article  PubMed  CAS  Google Scholar 

  21. Gupta D, Malpica A, Deavers MT, Silva EG. Vaginal melanoma: a clinicopathologic and immunohistochemical study of 26 cases. Am J Surg Pathol. 2002;26:1450–7.

    Article  PubMed  Google Scholar 

  22. Sharpless SM, Das Gupta TK. Surgery for metastatic melanoma. Semin Surg Oncol. 1998;14:311–8.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Pathology, Cancer Institute (WIA), Chennai, India

    Shirley Sundersingh & Urmila Majhi

  2. Surgical Oncology, Cancer Institute (WIA), Chennai, India

    Senthil Kumar A. Chandrasekar, Ramakrishnan A. Seshadri, Suresh Kumar Dakshinamurthy & Kathiresan Narayanaswamy

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  1. Shirley Sundersingh
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  2. Urmila Majhi
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  3. Senthil Kumar A. Chandrasekar
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  4. Ramakrishnan A. Seshadri
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  5. Suresh Kumar Dakshinamurthy
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  6. Kathiresan Narayanaswamy
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Corresponding author

Correspondence to Shirley Sundersingh.

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Sundersingh, S., Majhi, U., Chandrasekar, S.K.A. et al. Metastatic Malignant Melanoma of the Small Bowel—Report of Two Cases. J Gastrointest Canc 43, 332–335 (2012). https://doi.org/10.1007/s12029-010-9180-x

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